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• ~ (Page 2) • <br />MINE ID # OR PROSPECTING((I~~D #: /~- B g•-((a.. 1 <br />INSPECTION DATE: Z _~"CSf) INSPECTOR'S INITIALS: J~ <br />OBSERVATIONS A'' <br />C,ao-(Re-R.~ ~ .4 Pk-2Y'i&C. ~~ S pe~,v ~~ FaKS ORe,e~4 `7Za~.s IFS P ~a-2Y' <br />~ CL able. CoK37ZecsueA r~a~rtva~2cw~. O~ sxFe SAP ~f-+a~s-- RsrD 9`6fe. <br />(mac' (..~Foti~'~~N <FGY~L(JGT`L~° S C>~ R-T TfEe ~L +`~, <br />I-14D8 .4 4ueciC Y721P .g/L~~tAYq ~2 5e'~e ~ RetJCeuu 7Ne Ss~4-~zcS aF <br />~v62 ~~P A~R-eA ~ s 4'c t,L A R Y ~ ,4.ti~s ~XEe 9 ~-c c~a~GS trt Poz+osa rceu~ . ~lde <br />~ao-s'f'-~rASr a~ ~ Pap ,~,as ge~.~ R,~tae.+,cQp ~+--© R~c'ru7' (7,4e.~e.5 <br />(,~Rev'l 02~ ~~S) . ~W-e Po-v~U ~~45 ~E%4/Z L*A-P~4c.lY~. l RR i C-~-~zaxt <br />S`i'ST~o-!S '~sea.e STzc,~ aP~•¢4-e~~. <br />~p/~~lLvdto ~i.sLY a Gcsu35 ia~ aXl~ t~cf~Ysu~me-[P~.rfi `I~Fe at°~yar~ `S <br />~¢wSCr~.36 e-RB-o~-73 Se¢~c Ya !~ c~+~-tcc~6. <br />I~tA ~~-~ o65e.2e}e A~`t c~~cou,S ~R.¢Ss3~Ms. <br />I & E Contact Address <br />NAME: ROAM ~'tt~-y(.V7Q-(,.}I` ~~// cc: <br />OPERATOR:~i¢'~,,//LQ ~ IOU,~l3'T~LA.C /C.QS6LG/Q1`°~2rj `GUC <br />STREET: p. ~ . IE~pQ' ~ L' d F~(I}CC.6V10 <br />CITY/STATE2IP:_~ ~9, g('(S~o PLe ~ ~~ <br />s4a c.uc5;~ ~s~. <br />Jr0-~te5 ~7'e.~5 <br />^ CE <br />^ BL <br />^ FS <br />^ HW <br />^ HMWMD (CH) <br />^ SE <br />^ WQCD (CH) <br />^ OTHER <br />