Ministry of Energy and Resources Saskatchewan

QUARRY PRODUCTION REPORT

Disposition Numbers: Y-

Disposition Holder:
Address:

For Quarter Ending: Year:

LEASE No. Y Y Y Y Y Y-
Mineral Type
C. Factor*
Starting Stock t t t t t t
Production t t t t t t
Adjustments t t t t t t
For Disposal t t t t t t
SALES to
- Sask. t t t t t t
$ Value
Outside Sask. t t t t t t
$ Value
- Export t t t t t t
$ Value
Total Sales $ Value t t t t t t

Ending Stock t t t t t t
Note: Production returns are required quarterly. “Nil” must be reported where there was zero production.
*Conversion factor used: 1 tonne = ? cubic yard t, rounded to the nearest tonne.

QUARRYING ROYALTY REPORT

QUANTITY OF QUARRIABLE SUBSTANCES

(Total from Above Leases) Quantity
Royalty Royalty
Sales Value Rate Dollars
(A) Exempt cubic yds
(B) Quarriabel substances
completely processed or
Manufactured in
Saskatchewan (s30(1)(b)) cubic yds @ $0.05
(C) Quarriable substances
Shipped outside Sask. in a raw or
paritially processed state
(s30(1)(a)) cubic yds $ @ 2%
(D) Royalty under Section 30A tons @ $0.60
TOTAL
Contact Person: Position:

Signature: Tel. No. Date:

This form is authorized under Section 21 and the royalties payable under Section 22 of The Quarrying Regulations, 1957. All information provided
is for internal use only and will be kept confidential. Any published information will be in provincial totals and not on a company basis.

Two copies are to be submitted to the Mineral Tenure Branch, Saskatchewan Ministry of the Economy mailed to 1000-2103 11th Ave. Regina, SK S4P

3Z8 within 30 days following the end of each quarter (March 31, June 30, September 30, December 31). Delayed payment charges will be assessed in

accordance with the Delayed Payment Charge Regulations, 1970 at a rate of 1 ½% per month or part month thereof. Minimum charge is $10.00

Form EM 711 Jan. 2015