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n• (Page 2) • <br />MINE ID # OR PROSPECTING ID #: (11 \ "- s r1 (~~ <br />INSPECTION DATE: ~~~ I ~- ~ l C__ INSPECTOR'S INITIALS:_~ <br />OBSERVATIONS <br />1V~ Cam[ C`~2 1~1 Ft S S O M ~ d~ 1, IZ ~'1 C I C1Z '~1i11'~"r ~ - LL '~ L ~u~ 4MD L_ C <br />~SPCsz-~~ 1-~n c 3~ec~l~ 1~f (~~ ~2~ ~ ~Xp~ot?~+- Irv ~~1 ~~ h~ <br />UJ~_C ~j~ 1 ~tU P>'PcC k FI LL~ ~~' ~ C TI ~ C OF ~ ~-L1.(g~/~ <br />~~. cs ~>~,-~ t~ ~ cry gu~~t~ •~ ~ Pr+>~E - I m ~~ ~-~ <br />vJ tc S b ~ I N U ~ ~~ ca fr-i- 1~ c -1- ~ rvl c c~ ~ -~ c"1- l SQc2i I ~ ~1 <br />~ S~~z-1 L~ k~• ~ ~-SLc~ ri C(~1 Crt, o G3~ K I L C.. Pry-fit- ~ (~t O ~" ~Ja2 r~l~ tt~ <br />~ C7'~'~ <br />~ S 4 ~ ~ -1-U ~ ~ l~S-~ c_~ ~~S ~ r~ ffiR--tom R-~r~n o ~ ~ L o ~' T~Z-.t2~ <br />S o M C Cr(Z1~ I N G (^-- A-S wra 1-+ r( L,U rC Cr- • f~ P~ ~ ~ C F p ~ S LAS S( ~ f\f h-ho~.~i- <br />-tv~ C C o N S-f Q v_ ~-ty O ~I S ~`~ v. Cif C t' ~ 1- `i1n L ~H 1~ 6• I 1 ~+'2vSA~ w ~S <br />N ~`t-~ o is ~-v~ E w Pry ~ f~-c- k -~ -hn>C o S-t-1 C~ <br />I & E Contact Address <br />NAME: ~ "~ <br />OPERATOR: ~ ~ ~ V ~T <br />STREET:. Q ~~rr' Pj~X_ ~ ~' <br />CITY/STATE/ZIP:~_~ (~ n-~ , ~ ~~~Z~~ O <br />cc: ~CE~~ ~~~`S <br />^ BL <br />^ FS <br />^ HW <br />^ HMWMD (CH) <br />^ SE <br />^ WQCD (CH) <br />^ OTHER <br />