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i <br />(Page 2) • <br />MINE ID # OR PROSPECTING ID #: ~-/ •/q7~ -oD~ <br />INSPECTION DATE: ~GJt ~~~ ~iOGO INSPECTOR'S INITIALS:___;~LG~/ <br />OBSERVATIONS <br />c[ your s l~~~// of t~-ai~.p.~r..~apQ,~ e ~ ~JJ/ ~as 1c,ie/~o~j~~ ,rIY- !~C ~df~ <br />~~ G~ ll G*..~ t~'~ f -('~a wf TO c /r- /~r/u.`~/c/? /K `/Ya4ISr!^q <br />'i"L~ e ~f',J~/G~itr-e~ 7~ e ~i~ ~s cam- s TS l ( w~J ~ S~~/ <br />ac4~/e~~Lz~ ~it ~~ ~~ w~ !f ~ia~~_,Xr,! ~o ~s <br />tl7r /ea-rt~~ Sv J~ar,...._e,,.~ la~~..- ,~,~~ ~~o-t.~S krr'~'L"~es <br />~ ~/ <br />ar~/-vSS Y-ez,-,/r.e%~-~ 7`~nr~,^-/~ ~ rl~Y~fi- ~ ,1/GS f ~r~*..-! <br />~ot~-~~ll~r~ !"` /~c~f al~~.. ~ ~f4r re~u~-rc!`s4 !v '~ce o~ce <br />0 1 p I <br />a-,..~c~~~r:~ wr~ J~.:.,.. Dil~,e a-~ ~~ D/`fG- sla~f ~ k.af <br />t~o~~P, f.~ Cvc,~ y-~`~i(c. col„- ~ ~ j''z'-`~*~ teQ~~f <br />r~~;e~1,e~f ~/f ~~ tea.. ~S red'~9'/e~ ~~ <br />be ~~ sfs.~.,ar~s~~, ,-~ 1~.~ ~o r~~41r ~ ~rers~- <br />r~2~ ~e Kce~ -~r- ~fe ~~~s ~ ~ics ~s <br />Q ~J/-r/ /' (A'rv~~t.- t.~,-~- ~ e PJ-~S ~ f'J~~- ! ~ d1 ex~~6/~ ~o <br />1ZZ- O //S~(fe~ ~ln~'~o" l~L~~ fe~l wr_ or..~,~/~~~'~'+-~ w !~`i. Gr! ism C~G~ <br />T/$ ~2~_~G.//yiS~/~~G l ~ ~~'+- I /.L /N'e ®,L/yr/~ L~ Gi/~lG 'K~~lf <br />/(.~ 2 /ZO/-tK~Q'S~ GOtYt~i~ O ~ S ~(~~!/1"" Z~ , ~l2lf G~GLSr~- <br />I & E Contact Address ~fe~ <br />NAME: cr. ^ CE <br /> ^ BL <br />OPERATOR: ^ FS <br /> ^ HW <br /> <br />STREET: ^ HMWMD (CH) <br /> ^ SE <br /> ^ WQCD (CH) <br />CITY/STATE/ZIP: ^ OTHER <br />