3~
<br />rte
<br />;;
<br />,'he
<br />ioc~
<br />ape
<br />tep
<br />o)
<br />RI
<br />TI
<br />
<br />INE ID k OR PROSPECTING ID
<br />INSPECTION DATE 8 2~ 4fO
<br />~~~~~~t w~,, Ce~~ue~~' c~. E~c~~z
<br />'ll,p I,l~n bt ~~id~ ,
<br />OBSRRVATIONS
<br />Y
<br />INSPECTOR'S INITIALS Jc S
<br />~rwu~^ ~,1~ai,ec ~ ~~.a~i.1 ~~~~ ~~-~
<br />7 C1Jd.l `U.p 0.~~,ti~q G~'~.P ~ic~ ~P.llu.+~~~ ~ ~
<br />~~~.~ ~~.u^ ,~~kc~~c. ~71~ ~C~~Ce ~~ ~:~t~iu~~ ~~Ecc~~.a~~~~hi~~~U ~E+ CLfa~~s~~~~;
<br />~ _ n.
<br />-~ P~ ~ ~ ~u(,F ' ' ~~ ~~~ Cu>1zU:v~ ~ ~C: rut ~uAc f,~j ~u,~ ~~~s~ va fi % (;~ c~P.q~Cgl,~a ~7.
<br />~iuP.~,~ , t ~u ~.+torn ~rrnct 21k1 aufi (~e~~~~ L~.~~.~~ ~1ti~ fie. -c~~ L~cf~t~~i~ ifi
<br />-~ C<i,~l r~~.('e~+c~ ~~hu1111~ l~t~ 11~ l~ ~~ M~~>r~ 1,1t,a~'. I~e~.~M1~, ~a,+d. tt l~e.,l~~~L~cM1,
<br />~1uot~, ~I~'~l(~ a ~711,t~, ""I ~P)0(JU~Z ~JIG~tr~ ~'~D ~11691L4tG( ~~1.~' 0.~,b1~( V~ tC ~~ ~"~4
<br />Un.1~s l~`~ ~ .too +ce chit ~~+R Tl~ ~ c FCQr~+'+~t ate, cull ~
<br />C~,,.Tt~t~~ Uri' ~ 7~a~a1~ i1 ~~tiE;Pi+~2d~ w~. ~,1~ A,~p~c ~~ct }~~nli~, 9~p~Q.c~, l{~x.~t~, ~~.~
<br />~~Qct~i,~~ J1Q(' ~Lt `hun-~~ ~~.~iA~a ~ SO-~~L' r~l.~, ~.Uituti~2atC011cCUP l~n ~e~~t~c~' , ~~I
<br />~~~~uo1.t lu4.tA T eETC4K52 P..l~ I,M1L~l- ~ A.'1P~e ~~ 0~'~ 2M11 a~ Ee~cn~.(<r~
<br />Aa ~0 1~,~ , ~. ?z'x~.cc', ~t,;~~a ce~s~n~~ ~ ~w ~~~~v~a I~s~~n,'+
<br />cul~,~~ ~ vz~ ~2v~u~, rn~ ~ ~~ IuP ~~'~' G~v~ P~~
<br />~oe.+~ {dv c~~c~n~a~M emu, ~1.4~tic(,a (3#, r~6~~~
<br />,~
<br />~,~ ~r
<br />jLt~llu,iun ~t,M1t'Y1 G'VL(rlC~'i:~ I,"AIU,Q(.+ ~ SCI- ~~~ ~ ~j~~.l'0~',l'11 1
<br />.`ho~ cum ~~c )U.F
<br />~ Q,~cc M ~ e~~ ~ ~~~-u~u~-, ~,,1 nc~-u~~a try
<br />6"~ ~~ tug P I~ ~a~e~. D~c@ P~°~ ~ c~~w~~.' u~-~ t1%~ ~U~~u'-vmi ~ P~-t ,
<br />~~~
<br />ifi.E 7n~~titi~ '~~ ado ~ud.~e~ ~iw.a LE~nw
<br />11U,'~)L~`i~.Q(.~Eafzt~a~ ~~tt Iii ~u(~lDru~Unt(~
<br />`(~~p U~'~t0 ~.(C~t (,~7wJ fhLGUi,~,1C~PG~~iJl7<D l ~iQ f~cy
<br />16 E Contact Address
<br />~ KfZ. Jc{{(v A~'
<br />~~~~
<br />(Page 2)
<br />~~- 4~ -008
<br />~p~n,a I ~t
<br />~~ Q ~nc»ict ~
<br />ate, ~'i~~
<br />PfiRATOR ~ KcY'lCI.1I~ ~I~O 'A1t1D ~1I `~i 1X~~I~,
<br />TY/STATE/2IP _ ~%~DU Cmjt,~ c~lz~rj-W[Y~
<br />M1md ~ ~ ~ u,e~cv~ ~tu~
<br />~~71~~e ~nMabPl
<br />I~~oaua~~~-7~ . ~. .
<br />~c~1 C~ Q
<br />cc: ^ CE
<br />^ BL CERTIFIED MAIL 1!
<br />^ FS Z 416 942 272, RETURN RECEIE
<br />^ ~ REQUESTED
<br />^ HMWFID ccH)
<br />D fi
<br />P" WQCD ICH) (~g7~3 ~{UKLC
<br />^ OTHER
<br />
|