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• (Page Z)'d41 <br />MINE ID # OR PROSPECTING ID#: ~° ~g-~~ ~- <br />INSPECTION DATE: 7 - ~ z - ~~ <br />OBSERVATIONS <br /> <br />INSPECTOR'S INITIALS: ~ 1J <br />~1'~ lrs - ~ r rLt f~, [.car P/~a.3~CT wry s r- r~s~c.(.Y I,~s r ~'i~-~z,e~. Na-L,4sses <br />p.~A ~}Le~+foL urJ4S /,,~,~ecr2.J ;ns7'o T7,i-e P/~I~ 6~eiSS 4iQc.kf~l~C, <br />,4~q. -r-/.{¢. -~tp-`r~2cl+C. r 5 c+.trz2e.~17Z~S' B2t~}6 rrcxe ~ QY Pu/-rRrti1~ <br />~~~ /-r~(J45seS Aa3-J q-C.cobd-0L /~~~< c3u4' ar-° !`7Fe ~AQu (~E' <br />~/.~~ ~t !!2 , OS[ ~l A-L ! ~ ~e-~~"c-a N ~eLC. qiu~ Re~ la~T J-ecY~l~l1~ P4~~' <br />/~}Tp Y'W2 <l-Q u r rf=e.r2 YX(~Q.Ot1G f'f S7x~o oY7,~F¢/( Wza[.i.$. 'j'l~-2 s CY'e W /G(. <br />-~rz rt o6-~ c'ro1te. i} ra o a2 ~l~Q u e /.r r c, ~ Amw n~+9-r- rr~, Pc c.c3r ~~at~,r <br />I & E Contact Address <br />NAME: <br />OPERATOR: <br />STREET; <br />CITY/STATE/ZIP; <br />cc: 17 CE <br />I7 BL <br />17 FS <br />^ HW <br />^ HMWMD (CH) <br />SE <br />^ WQCD (CH) <br />^ OTHER <br />