Form ID

Publication date

Location of premises

Certificate

PBP-004 Paste Backfill Mechanical & Piping.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Placer Dome - Campbell Mine.
Address of Owner
Balmertown, ON P0V 1C0.
Name of Contractor
Gisborne Design Services Ltd.
Address of Contractor
7476 Hedley Ave., Burnaby, BC V5E 2P9.

Identification of Premises

60-44-000-001-290-80-8000.