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i • (Page 2) i <br />rv11NE ID # OR PROSPECTING ID #: }~ ~~ _Q 3 3 <br />INSPECTION DATE: Y- a 7-o-0 INSPECTOR'S INITIALS:~S <br />OBSERVATIONS <br />~~ l.(,IGf R n !? ~- o ~R r~~'1pX LuA.f-tp<~~+ /I~0 iri.-... ~.-./ ,.~-mod- <br />~ ~, ~ ~~ , . U n C <br />!°_°'>,"`.'~ ~-,-~ /w.e,_,/' ~.~0~ ~ erg-K~, n2~.~.« ~ <br />~~ ~- ..~ ~., ,tea <br />,~ , <br />..~v-ems cr.~~-k~"?""`". , <br />No ~no-~i.Q.~~"~ cu~-~r <br />~ ~ Ca,~1Z M o-u~ <br />I & E Contact Address <br />cc: ^ CE <br />^ BL <br />^ FS <br />^ HW <br />^ HMWMD (CH) <br />^ SE <br />^ WQCD (CH) <br />^ OTHER <br />CITY/STATE2IP: yl.~,_,4„, CiQ~ ~ g/~o oZ. ~o <br />