|
e'
<br />
<br />''•• ,, (PAGE L~
<br />MINE ID # OR PROSPECTING ID #: fv~-9~l -USv
<br />INSPECTION DATE (D~?~~Q'j INSPECTOR'S INITIALS
<br />pp OBSERV~AnTIONS 1
<br />~y iw4pD~~n wwS co.yfL/~ y /tYt51~w) +-p rSvr/P~l~ Q~I~//assess
<br />.~ 1~ U ...G~~lt- l~io wS ~-(/~rPr <w,,,7 ,~..,i`.~12.-y "`'~'tiv t'fT1~S bGG ~ w ( uJC -p1' l.a.P~ 5 ~e. ~j
<br />~7P,rn~~Ai Go l /'~ ~~ ( ,~ -~ ~~*'~~I l~t w~.R~~u/cvS ~p ~~(
<br />~,,/.;,.~ ~- ~ws,ryl~evt. ,
<br />I l I (It~(80 - t° 8n~
<br />~FP~~^~''~" c~nrea. wl-p~ BV~Ia/.f~~ /t/ yra/:uJ[~ w~,'~.Q- ..~~L~'.A~ rr'~tk~SC.c(. ~:~.
<br />l4 40 _ `(L~- ~~ S ;/d r.Ri -~ -I" u1 qre 6n-H.,,~'~ ~./M/~e-~,.~+h ,^I^I- Q-r 1,,,Q_ Cie ~~
<br />~~, CFiwf+{i5~ ~~.) IS ~/npo5ec~ I-C°r owP of-~~u °~"'t~-~~/''`~.~,IVP rI~I'+~_~-t~S-
<br />~,~Ir`n^a~6i J ~` ~ I V S ~ Ire'.evnl~l/~?y h, ~~ ~c~.p'f't s ~ It ~ Ne..`cw 4 ~/-~~~~tf~ n'~.
<br />iTc~ri:cY.F,ln.cFit i,/~T `s ,u;,,.,e- '~'f/'c~{' (-~`v ~D ' l~a,:.,. 1.,21-os~JF-~ tr'o~clt/' d-4-rvf' 4-t C- I ~S~
<br />p~e„s,f' ,~ ~- .p~,.ww~ ai./,°-~.~, Q'(Tr;+-~.i„zty~ .#~Z w~l,l ~;.vL w~-~~...Q~
<br />I,l _ 1,1 ,
<br />j(-w ~~'„ wc„/ /n,+r,.~"~ a w r ~II Iz ~~ Y ~- I a ~ vu+.,.2 i" ~ ,9C.o ~.~{~-, 1/~~o/c-~.G~.
<br />'~t c• ~iw' f /i1.v/ t'45 C' o~~y ~ '~Pj(~1vG /o `(~ r~ t R,P.~..,Ge .( .H1TT-aMn~~/Z
<br />+cT li tN i 1~/ ~ ~..t//e (, /C'~ oL.rf7P~lDPIL~~w.fµaS o ~ ~Jcn/~ /~ -t' ~Z ~p ~./ cw-cw~
<br />FjP1+-Vcr/ C~ CwS~- ot~ ~ 1 Gw~cP..~,
<br />pp
<br />/'~ _ ~7 ~ ~ p ~..~ ~.. ~ M. l iJ ~ r.i S~`~- ice/ v Q~ ~rpiN,(~v1 r.-~ ~a.~j~ (~ inw. 'S ~.LCi
<br />~.w(.
<br />p,revt6'J4 `Q'Y~ ~~ u/~ 11 ~ G!/VSO ~I ~'ECGL Iw `~S /~7I+N(/y~~,i11.y IS
<br />UI _ . _ ~~,.,,Q` •~I•I,EtAi W Y~ S'.~ "' ~ (~[ ~C (V~ ~ ! ~ iT~ 1 w GG, ~t~w~f (N~
<br />;~, ~ ..w Nw111 e r ~'GV~, G/dGC~1 N~ ~YY L`., T "`^- I~DIa.cQ- v~ S ~-v~e.R.t..,.~
<br />~iro ,,,,, ~.I,(,,,~ re ~ . '11,.~ 1 Q-p p' a ~ /d c,.c~ :~,,,.~ ~ ~-s -~cuQ, C,. i-3 V ~ w._
<br />I & E Contact Address//ll ( 1
<br />NAME M-I~ ~cLV'K VV F,.~nL-k-/ - CCU J i.w S~1/e,,,si ~ ~DI~-!r
<br />OPERATOR / r'~"~ 7 ~j°t:''"'Q~/ ~O~CJ{" ~e~.l~.vo c~
<br />STREET ~i7~ E ~~e-S ~ew/.~ JicVP.i S'~3o.,~c~ ZuJ w/ B,;,P~.Sr '(~o~
<br />CITY/STATE/ZIP `otara.~o SS't'~1.y5 ~ $~03 ~01~'~0 SF~I~s ~ $C9Zt
<br />5149E
<br />
|