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<br />MINE ID # OR•PROSPECTING ID #: p(1,/1.^ '~^j~4'U'
<br />INSPECTION DATE: ~~ (~ ~ I P~ INSPECTOR'S INITIALS:~_
<br />' OBSERVATIONS
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<br />~& ontact Ad ress
<br />OPERA
<br />CITY/STATE/ZIP:
<br />cr. ^ CE
<br />^ BL
<br />^ FS
<br />^ HW
<br />^ HMWMD (CH)
<br />^ SE
<br />^ WQCD (CH)
<br />^ OTHER
<br />
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