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<br />MINE ID # OR I?ROSPECTING IrD # n~ //l:-'~ra~ ``A
<br />INSPECTION DA'.'E ~'~G ! ~ ~ INSPECTOR'S INITIALS ~J (,)
<br />OBSERVATIONS
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<br />x} F~ Pfio ~e~ P hf~t~'Se p ~ R, c ~ aa.«.: r
<br />~ M r a.t e ~ p S t 6 c" F+r~-5 /~ 2e~.r ! ns s z-q-t.i,e t~ l~ ~- 4"r-r~ e.4 s ; ><t,~a=vee a F
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<br />Cv 3 5~R ~ ° c~ e cu LrY CS~e F`~r2a o3i...e o 1 _ 7ld-e ~ra PSCS i C. Sae IBC ('r e.C S
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<br />S~ C K P a L e-S ~as(J Q /L~r4-D C~~-5 5- 5 ec~.i~ cut YE~f- `7-r~F a /+PF'Yla-i.-e
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<br />a ~ 'T'"ra-e '3 ~-'r7, sF'~-YS rr"t r r 5 i S cam 51 ~~Re A ~ !.s e~ t a a-z S (~L<°~c~-~'
<br />~ u y-dq-~ /~3 ->..~^y ~ e~ +'~ o e. 5 ns o ~ w`!"r d~'t r 'T / ascc.c.,. 02 ~ r er ~T66-d~
<br />See` M;X. 5b~~.e -T' fS cavLY ~1- Yt-rJaT2 Cotis~7'rTueN7clz
<br />-~@. tR l tt. r ! LtiSd LC. aTtsT' /56 !~ /°26"/54Bp-d ! ~ rT /S /lTQ°i- c.L S2tj ,
<br />TdFe.. aPe2aq-~r2 srn.ou.c.~ Sn_e~ ~'~!~ zzsr~sor~ STt~eKF'rces /~er'~on~
<br />Jl.+a3e. Lr Easq~
<br />,~In 6T63z•rz PR,~l3c.erYd~ 6a5eau~p q~ ~atss s ~ re.
<br />.1ta-r S~versS
<br />I S E Contact Ad r /ale
<br />NAME L. e.IQ.CSr7~ A-/LG ~~ ~ (~ . ~ r
<br />OPERATOR Ltr'}C.~-~rQ //,~(.r:qj~~'~
<br />STREET ~~~, ~ CS)f '~{+7 ~~p * ~ p
<br />CITY/STATE/ZIP Sd~.Gu~csa.~ , ~-~A-~ ~~ ~C" /
<br />
<br />^ BL ~L~
<br />O SHMWMD (CH)r~L/J-F'rCrSr~~ ~O.
<br />^ WQCD (CH)
<br />^ OTHER ~ ~ r @ r
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