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MINE :D # OR PROSPECTING ID #: ~- q ~ -Ogz <br />INSPECTION DATE: 8'Z G-~Ss' INSPECTOR'S INITIALS: G /~~ <br />OBSERVATIONS <br />~l. i~ Htaoe(lon ~'~O ~.,,ff`rr"°`"' ,,,isl aed' -F-.f ~r-r.~ <br />/• ~ li~~l~' /~G7d+1 ,.v~`O XIGs' ~[~$r-~-(t I-y 12j~1 ~~ Goy..c/'J lK/tc~ fo/„^''C l~(,/lJld+-~ i <br />TG.a~ Fr~ GQ~~r~y/~ ~,~r ~,.~ rko~/ w.~ OIL, /1Z°Q t. /GoD ~e~~ is l~ w~f <br />I~G ~J wow ~y~,~ ~-c r.a•f-!~y ~~ G`ii~6rec~_. <br />2r ~ Ic~•tu~ cow..p ~id,~.-c e. w~I![ k, torr~l r v2 2rif lot-.-f requ ~r~0 fo ab~ <br />~ro 6 ~ls~... f l(Z Q"~d~ 3 e ~ !!-i.t S- Z~- p r ccc f~~,r%. `j-a/ar`~a a.-~~rv d ~tv~- <br />rCysc~ L.al~~/~ +`~r a«oi..cl~c~(~'"`i o<-~- ~-e i>-c~~l.~.- S tolD~ Kr. <br />ra~ ~..~ ~ .~.~ sir ~ ~ ~l.~- . <br />/Kt". ~.atcOZ~i G~~l++r[/~,.y//rn LGel 1D?I',~jr~ l~r/urQ~ vl~- To P~Cd/-iliT-e <br />D(^t~,,Gyy~+~~,T,~/ d`~ 1!'~-'G!~ f~Grt~ u~ p~¢~,~ Q~ Y/G((~ KPCGfI~ <br />(ti !G~-C w GJl C/'>1 ~~we ioc, ec ;v-qJ /Ki/-- _ ~r. L G~t..,.«-.! 7(~~ j~o <br />~it « `+--~ ~6 r-tvtc!/ /KGs ~s~ 1 ~a.-~-. ~' ~ Yt~Zp~~xL,6of <br />_ [f~-2) /'/I.LQli~~-•er.G ~aJ l~.l~-~ ~ we!/e/~- ~, t--c~~(- ]~o scea.~ <br />vei~~,.v.~ ~ e 7~,.~.a d ~ ~c i s zH-I~{G~oh- ~ ~.-ejl~rt2 ~: w~ <br />,- j -~._- add ~s ~0 3d .r°~•~ ~ ~' <br />~ / 1 <br />of S tN-7e~p~ 7~t r~~ Il ~'`' / <br />! <br />G~ ~i1-S~ J~ Q GL~ ! <br />~g.cct oar-- K ,py-~~~ ,.,c.2 t/ !~ f <br />I & E Contact Address <br />NAME: <br />OPERATOR: <br />STREET: <br />CITY/STATE/ZIP: <br />cr. ^ CE <br />^ Bl <br />^ IS <br />^ HW <br />^ HMWMD (CH) <br />^ SE <br />^ ~NQCD (CH) <br />^ OTHER <br />