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(Page 2) I <br />MINE ID # OR PROSPECTING ID #: ~~ Cg'Y7 ~~ ff <br />INSPECTION DATE: 3-H"~ ~ INSPECTOR'S INITIALS:!~7~ <br />OBSERVATIONS <br />tt.sz ~-Yt9 L1e-o3'~~. ~a-~ ~°,~bc ~e~3~S G~c.t.~.c~ nctr`T NJSP-~~'t' <br />y6dti5 S E~2, <br />~y~, I-t c eve ~ S 6 G-o~i~ w~da~ o p3 ~-~,22c~~ !4-Y" a'r~e. e~s$~ a~ <br />~ ~•t.L R(2-S.e r~-e.~,w+_.e T~ 5 G~1-S fze-e-R2~1. <br />I & E Conta~/c~t Address <br />NAME: 6K .~sRO d <br />OPERATOR: QI°',Q-7QnnEG l_,ISL(hYf'Y <br />STREET: /' ~ 676Jr' ~ ~i 7 <br />CITY/STATE/ZIP: ~A.12 A LL} ~'1 ~~ i5 ~~('~ <br />cc: ^ CE <br />^ BL <br />^ FS <br />^ HW <br />^ HMWMD (CH) <br />^ SE <br />^ WQCD (CH) <br />^ OTHER <br />