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• • (Page 2) 2~fI• <br />MINE ID # OR PROSPECTING IUD #: /t9- [ q~ - ~o s `~ <br />INSPECTION DATE: OG~ Z~~-~Z~G't~J INSPECTOR'S INITIALS: <br />OBSERVATIONS <br />1~f[g.~-..,L ~/~ -~.~~~~/ ff°~~~L~1~ ~ ,per{ G~ f ~ ~~- <br />~c2G~'f //o v/~ /; ~CLv~f...[e~~t~/ ~~ ~`-w~- e /~f ~iF-~-• L t <br />w°-wG.~ b~° 6eIJ~f (~ l LLGSe aT~~1 Co~~/l D~P~~ ~~~a <br />C Cn~ U ~ /vt`f VC~~ fe ~ C ft ~ / <br />~~, <br />/-~ t ~ e ~p~/ cis--~-S~/ ~ /~' ~e ~ef~r~cc, <br />~cr/'w~. o-I- ~e sf°~Lc~!`B~//~"oGdfjt~ ~'~`, „-,c.~rG o~f <br />w ~~ SGa `~~ <br />~~~~~ ~.•f ~rr~y 6/ <br />~ ~.~ ~c ~ ~~ ~~ <br />t G~~~Yac~~ t~ ~ ~~ f~ / ~ Jl rs«l ~Ye . <br />~//~l~ +*ti 2`~~ ~!/ Gout tP~ - G~'c_f / ,,[ /~~j <br />l~1~ ~~f ~~ ct JBiC~ ~-~1 G~'"'~° ` tac / l/ /y d.Z' //mar-~ <br />~ / fo ~P D/~!s/.~- ; <br />~~sf ~e s~•N~~C~ <br />l°~~~- • <br />I & E Contact Address <br />NAME: <br />OPERATOR: <br />STREET: <br />CITY/STATE/ZIP: <br />cc Cl CE.. . <br />^ BL <br />^ FS <br />^ HW <br />^ HMWMD (CH) <br />QCD (CH) <br />^ OTHER <br />