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• (Page 2) <br />MINE ID # OR PROSPECTING ID #: /`'/-(~ ~- /G 3 <br />~ INSPECTION DATE: 3 - 2 S -a/ <br />INSPECTOR'S INITIALS: ~~~~ <br />~~ SERVATI/ONS / ~y <br />This w¢I a !yt vKr<o/-ii~ «fPe~~~.. Gf~-EG>K G~oz-+^~~~D-rte t/i1LV ~~° Peh~,o~ <br />/`~~wC~rln... f lfow~ sty. > ~;f,~il ~(~ - r~it~v.G~s-- , Q'lL~d+~C~ <br />~~. / <br />7~-e o/~J ~f ~~~ ~ ~1 a ~e a l~ w~ f~r ~,, `~ -e ~er~ ,'~ <br />~iG(/~«D~CES~ 2 j CYirz~ ~~rtz ~~97 , <br />~e d ive~7~sy- c ~ eX~l-atil ~i~-~- i J ~n /~-~- e e`Lf ~ /~7o Cs~~/,~ ti/U~r1~~ <br />Y2. e bas 1 0 ~ e~ ef~ti,c~ CXfr~~ iS a roaa>d 6~~uz~ <br />li /z~ 7z ~~, ~~t e vu ~~ is~q Sri/~ e ~S f ~~fGr~ ~v~11 s/Gr ~ ~ ~ e <br />Plrrn+~~p~'~l R~~jf~~/~efs~+~/~~L~-,11~ ~~/' ~ilyd'i~/~~/t~/~~oo~c~~/` <br />Gf/fL4~IP~ w/lG~./CY: /~'D/!~ /~e//d~~.~~a''sJ l.G/GL~C/(uV(Q ~ /u-e G <br />+~G~~ ~'-~ ft2e ~-.~ 6o«/'ov~- o~ 7~e f~e~~-~f a~~-. <br />7T e EOff~rf tjo~e ~ orr~ s7Lec c~~ -~~,~- ~. Q~~~/~rr~/y~~~;, <br />S ~~ca't- s/!e 7`o JJa~~t'-r [ ~ 7~ ~ ~`/'e Q ~o d.-~, aa~ ~"o /Y~ ~'dzy~-G . <br />77~.e Go*-~r2~y t~~a-~ tyf G~N*'~'yi`. ~~ /~~~~ ov-~~r~- h~e ~c/e.~ <br />->°~o~-/~~loS~y o-~~ fIT-e <br />To ~~~ ~s~vf~~(e f ~ ~j~~' ~~ ~~ <br />~r~-~- eroSro~- ~,~ d ~ fi~ ~ <br />veg." pp~~yy~-•/- ~..p~,...s <br />I & E Con t Address (~`j ~~~ n~ ~~~~/~ <br />NAME: GAP h~ f u.~2~~5 ~~ ~(Q./LN-4~ <br />l ~1_ <br />OPERATOR: Las ~ini~ S ~ i~,~„!„ <br />STREET: Z OD /_ / ~ rQ ~ / O/-~ <br />CITYfSTATEIZIP: <br />cup, ~a np'~Yc~iCv-~ r7~'ti~- <br />fe-f'~~a~'lol/~~' Qom ~t <br />~y,~~~ 6~ <br />cc: ^ CE <br />^ BL <br />^ FS <br />^ HW <br />^ HMWMD (CH) <br />^ SE <br />^ WQCD (CH) <br />®. OTH R <br />,%, ~- - S ~v~-S - pnC- <br />