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<br />MINE ID # OR PROSPECTING pID #~ 9~' ~/~ 9
<br />INSPECTION DATE ~~/~~ /~ INSPECTOR'S INITIALS~~
<br />OBSERVATIONS
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<br />I 6 E Contact Address cc: ^ CE
<br />^ BL
<br />NAME ^ FS
<br />^ HW
<br />OPERATOR ^ HMWMD (CH)
<br />O S6
<br />STREET ^ WQCD (CH)
<br />^ OTHER
<br />CITY/STATE/ZIP
<br />
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