(PAGE 2)
<br />MINE ID # OR PROSPECTING ID #: ~- ~/-O l,ct,
<br />INSPECTION DATE __~~ --~ 6 _~ L
<br />
<br />INSPECTOR'S INITIALS J--
<br />OHSER~ONS
<br />T~+s z NSPec ~ !©,v uaq.5 Con~r~ua,Te,p ya S Re e?~e i Ke p ~aa f~Nen)O r'7e.~'r
<br />R2que.s4's: ilr4t:Cp~2NC Su~Mrrrel4~ ,+~ ~Z2qu~SrTO A-~e..,D THei/Z
<br />~QRMrT RsteA, 5-'Ne. rGhle~JlJC'p f}ReA c.x;iu. H~+ve ,q Ne7' in7cr2es~Se
<br />O F zs,~z ACRt~, l/RLeer rNe, u=a+~v's ~ DQO>o /i.z8 q~,aes cn) T,~Fc~ e,4sr
<br />St De c-F 't~!-Fe pen~.,r (.r ,~.xc?a q.e~,qu.s~ T#e Gs}ntda~uJnrert ,4.~,eWep rgnl
<br />1 N Du SrRt R-L CatrR[,G~C T °`r %'~ Par~r~y
<br />o ee. /3ur~~-„whreNrrnr2aFeav~ (.vrLG .vaT'/+cc.ea.9
<br />VAUCe S'~C, `~'o t1 r rUe i N,z ,~C.R.eR~~2, ifir}LCO; TnS~, /3C.c~r-1rReD Ti{C;
<br />21C,F49'r FKtoo-( 77~{e. L+~~Jf~DwnJ2R` /rV ¢xCh,4n16e ~oR TFf-e I/,2$ AdQ~4jTo
<br />MIOJe T~ K4 <FO x.12¢ `T'RL~Cy- ChrJ ~He SQU7'HV%25q' S1De of T/Fe /~rz+-rrT
<br />gR.eoQ- 1)25GR.r 62D ,4s v'H2 Swl4 rsf=l~4 Seez-ro,~3 ~3-~^!g s_ R 26w 6 PM
<br />Guh+vr5cs,) ~vuarry• i-I~IS PrT r5 c:~Cq-7~1, ,a/,~a~..~r 2rr/G.es sour6# t3-f'
<br />~' f2,e3vcA Eau ra-+2. 7"N2 C~tR,e,ewSr pe;pHlT RR4.~t Gc~.S/5Y',S a'~ /79, 34 f7c++eeS,
<br />~F r}PAacu~e4r i'He ,4~rr,.croea pe~erwt?',q.~ r,Jcuc,p eo~rr,9/nJ aa8.o6.4reeg,
<br />7'ife Rc~l-r.~; PrT rs r-Iru~a !u ps+r4se3, ~k Fl{A5e wrLLCcw+srsTVf siPPRoxrrrit7~c.Y
<br />ZO RCr2e4 . OF 'Tf1e Lc ~4c'.Re5 iu I}e.2eS u;oKC-~ /,j.s HvF,j02 r7/S'fA/~BrPw2.e_ S A-~`~S
<br />Kar~er4N-7'Q br57uR8r1+~Ce /+,JD 5R-~'Re5 HrtiuK O!S'T'uRBRace... `Tr•Fl' Hin1C' 1S /n1
<br />~.`.bMPC.lgduC2 WIT F{ 'j'/{e (~1{1@Sep (~[r.41~?+
<br />TH¢ 40 a~rze TRnvCT /3eresG gr,oea -ra '7'ae PeQnc r ~+a.~v rs PROPen~Y rr.aRKep
<br />AS Re qurlte,p !3Y /2uc,2 6.7,
<br />'7'/.~2 [.!}rJDcw~R N145 R C+4R .IUNi1 5%F{R1~ Ia Tl+e FAR NC9¢Q'kF2,gS1 C=DRNPIZ o'~
<br />`f-!#e -4o R~reRz -raa~v- whrc~ F{e N~5 A6/1e¢~l Ta RQrta+re !~ /.4[CO, ~,
<br />Dee r bes 'ro r-r,nte Ti4e 14Re.A~•
<br />if {{l-G~~,.~0.?~ k.(A5 SuccE55~u~t.~- Reu~6e~a-7~~ A,~,er o-f Thee pRe-~~4ct) Pi
<br />R~szla. `T{F2 !{C2e..4~e rF145 A- C-~cx,D 5~-rF.vO ~ BRASS.
<br />u:AS
<br />flrJe PR,egterl^n:oY`ea 1Ni ;Fle HrNFntCs Rl.~trv. TirFe I-!/n)C' I.Y LI~*'rIU'f? --Qe.SS
<br />7-~Fw-aT !~o ~R~'~ Pe,p 5~,~.~ ~-NO °r~e2e i~ nro MRa~nsre~ ~ei~r Tae tiir~lntb
<br />P~rR i.7 "rb ReM14FJJ o~.-tR" o-~ 7'~rfPaaaaY C¢sSa-rra-J. ~R Rum 1.~; L "TNe
<br />I ~ E Contact Address
<br />NAME - (~Q6 6e ~ e6~', °C: .Jlrt STevC.~eTS
<br />OPERATOR ~ J ~t . ~r -~~ ~
<br />STREET
<br />CITY/STATE/ZIP ~ L~/~At[~
<br />C .n Al ~?n.
<br />M:MIN\OSS\ERN\INSPECTI (10/92)
<br />
|