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• (PAGE 2) • <br />MINE ID # OR PROSPECTING ID # : /'/' /~"~~~ ~~-~ <br />INSPECTION DATE ~<-~~~~ I ~~ 199a- INSPECTOR' S INITIALS /~ <br />l~o~~ 33 ~ a'~a <br />/f(OOa'tleua-~ion <br />... ~~~ <br />]: & E Contact Address <br />NAME <br />OPERATOR <br />STREET <br />CITY/STATE/ZIP <br />rS:MIN\OSS\ERN \I NSPECTI (10/92) <br />cc: <br />