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I <br />• (Page 3) <br />~ MINE ID # OR PROSPECTING ID # ~ V~`y~~ <br />INSPECTION DATE LfZJ~Qd INSPECTOR'S {NITIALS~ <br />OBSERVATIONS <br />~-3 <br />U i•~-~ ~ ~ ~pe+r~o v ~.,~. ~ .~,r u ~ (•,. ~{' A.5 vr-ei ~-~S ~ i w~ <br />{ <br />l ~ ~ ~- IrP~.,.o V ~.,Q~ <br />II <br />0~ ~ tl ~` wIG~~ o/' <br />GO <br />~ / r~ ~ <br />, <br />.,~, <br />w~.uti`~ e,~ ~~ <br />~Q~UVl4~1 l l <br />Q <br />~! 1 ~, I 0 ~' L(./J~.t`~ ~ ~ / <br />~ <br />AT ~ ' - ~v~' ~ <br />l Q ~ 0 G.r~p <br />I <br />~ ~ Dvu-~u~ ~ "f6~sd <br />L~~ <br />~ (.r.~~/~y_~x <br />~azS 5/r•~~ <br />GS ~~ <br />,~r,~ rjl~5 pD <br />pp <br />S~uvlw ~ 5~>•wr•C, ~v- q/,1~~,u1-il `1~.. 4~Su. <br />~ut k° ~- ~at~r' Y~5 l w~,c~ ~{t-~*~w5 ~ek' wb ~-ei sv~i.,,wtKd, <br />ms's ~„u ~,~, , p,~D~ ~ r~l ~~-~ -~ ~ Q ~ ~ ~ ~,~--o ~- G,,,~. <br />YOU h/l. + kf/"` k.G~V 4 H~"J C~ . ~j ~ ' <br />` 5J~ ~Ov ~C~./1 H^uVVV~.~r W~~. ~ p~-~/'9V1rNn.GW ~'/~4/"' ~"~,~~ <br />i l~~oc,~,f.,.-- u{~.Gt'utp,r C6c~ Ca/~)j (~.~{a1v~ S~rik.cl 1996 ~~ nVe~, <br />~-~ i S w s ~ ~. wr,,,r, w~~w -- ~N.w~' ~ f'f~t.! S 5 i~/ <br />p I <br />S ~~w5 ~- u,r~v C~-~'~i w~f•+r~ U b S trY ue <br />iW i ~ Y~~v ~ V ~/' <br /> <br />f1L/'So ~ 1./~nN W! ~4 YK~ dp ~~ <br /> <br /> <br /> <br />I 6 E Contact Addr~e~s ~s,~1~~ ~ I <br />NAME _I / /~ LA.r"`~-~ U4' LVG~ ~4,1I~~~1 <br />OPERATOR C.~~ ~H'L. <br />STREET ~ / r1 /~~,'' ~Z'~ //,A, QQ <br />CITY/STATE/ZIP IH (~ 7~ ~~Z <br />~~~,~ . <br />cc: ^ CE `I I /~ <br />O FS V~ {.f D/~c~.wl~Z/` 1 <br />^ xw l ~ J~~ <br />^ HMWMD (CH) <br />^ SE pp <br />D WQCD (CH) {J az 3S'v <br />~' OTHER / .. / • ~~ ~ ~' ~V,I_ <br />