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• (Page 2) <br />MINE ID # OR PROSPECTING qID #~~~ r-a-~7 <br />INSPECTION DATE ~-64"- ! 7 INSPECTOR'S INITIALS~~S <br />OBSERVATIONS <br /> <br />~~~~~~ <br /> <br /> <br />~--°~'~ fo -~-- o .v ~ s ~. <br /> <br />I 6 6 Contact Address <br />NAME A l i ~c a^^~ 4 9 A r tn~u ~ C^ h ^ n <br />OPERATOR R~/' 114.~L~ d-~.~X o-wY /C~N~w~tX <br />STREET _.2i y' `J ~ 7 ~ a~ Co-µ^/~(-UA-d~ <br />CITY/STATE/2IP keo-ones bHrg~W ~'~Co `~'~ <br />cc: ~ C6 <br />D BL <br />O FS <br />^ HW <br />O HMWMD (CH) <br />O SS <br />0 WQCD (CH) <br />O OTHER <br />