|
~ •
<br />(PAGE L)
<br />MINE ID k OF: PROSPECTING ID p; I'Vj._ gL9- OL~I
<br />INSPECTION LATE _ (/(3~cZyL
<br />INSPECTOR'S INITIALS V/ /
<br />~// OBSER~IpNS
<br />~~ ~~de-u.-"T~n-~w,C. ~CC~[~p~~,yu_.c,~Q T~ 1Ja vi sr a-~ . ~i.~2
<br />~/~,~.Co,Q~y, i 5 Wrir~u~q ~o c/w~.,eC// r n e ~ ~ Jh r n ~ ~ LM LJ~. ~ ( /"74
<br />/ ` __pp
<br />~~~i.o,~ ~+~, _ %~.e wade.. 7~-eo~i~,~.~ ~ z~e.~, .s skc~?_„',~,~.;_ta~
<br />V a,.,~Q /~s ../q~~s~,.-7 ~u-~.~~~ dy ,Llit^e~s~f~er.~ ~'l~er- .~ Z~~,l~..-,
<br />7K ~.¢- 6p~{o,~ r s /-e."wv~ ~ / 77^.~-C 0~ ~-2q(~ r2 tca~ ! z v[ sca-,
<br />~Jrru.i,s 6\ _4,u.~....~.~~-~/ ~~a~L. /rt~~.oP.E-a- d~.~/ ~.Ze,.- -lr/~; ~s''~~~('~~,,°~,7'~~fa..X`'
<br />rv !~ H7 YLS C.py~ a /h-K- / 2/( CC~n !'n-..~5~ '3-c ~,/.~.v~^ccl' ~ [~
<br />~yz, C~~ei -{~_~e~z` ~Gw..a~ ca,,, 6x ~ o,.~d2't~. 7Z,.a._
<br />~.et~`~ ~,,,,~(. -~ !.~..,..F' -~l,R s/N_d-fie ~~~r1 ~ ~ a.t~L.
<br />rvw~..e ln.~ Q ~ a.6~ ~ , S ~ 7~ S ~ ~c2i _ 76r~ ~,,, In y/..C~ -(;
<br />ls~.a- a,v. /vpDs//S ~1(fQ.,n~.~..~f- ////~"" ~~~~sela-~~ ~ (~r~~n, C°~~/ -
<br />~7 ~.Rc_4D-~v~ ~?!l~ t n M~..t~ ~L/ S / G~ Ll~~y ! R a.e aw4 ~t ! 1
<br />l~c.mLC.e.~~o o~.~~q /~~.e~~zo,,., -{vr ~7a./`^(-ttp ~„nnL /'~~LV O~Y' S?U.m'rYY~-~
<br />R :.~-q3V , ~.~+/ 6z.~..., nloK ~y~~~cc ~/oelc -1- Llc.!-~ ~~ ~ - /.
<br />,a'~a,c.zX ~"--~cQ -~G.R- ~<l~..s~ s ~a~.'i-c- „ '~° Lov~.7~n'w-~ i-u-^ ~ 7r1.e
<br />1~,7~ ~~,~ S y- /9tO~2r~ /C~°'L~Ti ~°./_,ec.-r C.Is.R_c~c- ~ /~~ e ' `,, ,r.`han'~f ~ h
<br />pc.pz e.2 -~ ~a~-e- ~ ~~ ~a~~ {a2~.vf-- 7rn- MSC xq~
<br />~A. p~(~n.-~.r /5 .2Va G.~~~r rerr~a/~ ~tnC~/_~a~-v~.Q
<br />fr11~ --i(// ~ T(~¢ `~.u~ l.yo~ S'/ W t.(,e ~iR// ~.~1i1{.~-~oQ / ~ q
<br />,y /'2c (a-vrw ~!_~~ ~~e ~, .~.c.~/c~ .~fitrwJvr-~ /~ 7~sc~+^Q -S H/~ /'~~
<br />~C (~, ~w ~L,LwL ~ iYL Scs~~. / /~i /I.R -fzrrr~ Or/ or -r~r~inc Oa-1 /"'Cvi 6(tyr
<br />I 6 E Contract ddress
<br />NAME Sfa.vt Selarac,.<-~ ~ ~.ep~ Q~th CC' r' ~a./~ /{~,~,~
<br />OPERATOR ~~2n-{ra'Q ~, ~~i Z<d°~a.~ /Ll~x~nq
<br />S iR E E i _~ ~ $S y~,w~_ ~-ri v~E!_ ~ ~a~
<br />CITY/STATE:/ZIP rtr~a~, ~~ gooo3
<br />5~a9F
<br />
|