• • (Page 2) •
<br />MINE ID # OR PROSPECTING ID #_/LI"R~ "' ~(pS
<br />INSPECTION DATE ~{-~~~ q~7 INSPECTOR'S INITIALS sSS
<br />'i"4 G
<br />1 / OBSERVATIONS / ,~/ 1
<br />?~l$ fiJ 0.$ oi. rOcJ~l trt ,~ /ti. 0/r; YOl r; rl G( (/1 S~ eCJ T'7.8 ~) Of `f~.e ~( a ~eCr'~-Q~CS
<br />N1 r n ~, 5' l ~~.t.0. ~'t. ~ a.P Pro 7rt M (j P 2 (YJ /Y M r fie. S rl [] CO N/l ty raot.a, ~Oy d ~t~
<br />O~ (D,r,can~o~ ~n(r La P~a~r ~.clwt~y, Tl'.>/ cq~~a~f~l_ ~a^GrosS 'E{.~ ruar~ accP55
<br />r'Oad ww5 (nY0.c'~', Preve.~'(`~~ V~2~1(ccc'ap 't-r4++,L ~-o ~-(-.~ Sr~~,©/le
<br />O~-~..~r QGcpSS road- I~a~a 61o~~ed ~/ 1 !`Y~~c_nl l9urr(e.< <ecco~d,.,s'~~
<br />'K`f. 0 P~Crw~or, t7~
<br />~Tl~ dP'Gr0.};qn Corts;s'FS OF n o(ecrC~-~vo Fed, ~ ~eaGl-; Pad. a ca/~1"l ~+q
<br />rr (__1
<br />Q CfIAS ~.'Cd ert S'~ofo Q, (x C'e~r'ru70 oce., b1nSr }-w~ Wa~ ~-an lCSr a ~Nty
<br />G~o.~2+' d(/Cf S(Oit d(~ a.~oVe 'I'L+e I^ea#,1 leucl~ P°d~ gird varto,,.a 3'unke-d
<br />PIeC~2$ e'~1 aqu~Prnln~ `FS1rc•~cl~caS,
<br />tit O~'2'rA~-eje' S~0(nId C~P.etrt u~J Th,{~ ~ H.,ked /h-atpfra~S ~'I~~Cn~ 'F(1~
<br />S(~Q, +~.a~ arC aSSaCCa'I`p,d ..J1~~ `~ln.e_ oO~e!'n~-(n.,
<br />~-~.,e.re, ar-e. i-ou.r e~rrs~r,,c ~-a;~r.,g Pads a~(i~ „e;}-[-,~ sr~-e~?1,,e5e~.Prc~aw
<br />a~S ~0.J2 Qen r V ( e wrtdb eperrk;
<br />6 ~tt~~ ache uy~t I ~ n~ mc..t~¢1' m
<br />~.c~r.,~ ~er~lo~n, ta~.T~nCM~~~~S e~Press ~r.~~<r~f r~ processrn9 eke rorJc in
<br />'I~{,est acts a,.id- r-iµs~l- S„~b,•.c,~ air ar~c.tndr..tc~- i-o rnclµde~-G+r?w~ r~+- ~e_
<br />~erw~r~arC0. 6¢~orG C1~5'~r br,, 'FG.ewc,
<br />`rb•~ere_ IS also ar, aPeare~^~ ~osP~ec.~- on sr~-e ~~R~ bV4s r,OFp~ rn fl, rgR
<br />ins rc+~on, i L. ~qs~t ror.k a.rd or,e_ sloc~,prle. ~rn.-•~ ~~cs cos ec~ r5
<br />c~eeos;~~ed Su,~>,'~`a a°~l ~-~.t ~e o~ ~e ~ollZs arC'. adJ-ace~~ ~-o~f-l; ¢. Gar~ts
<br />6µ G(~ c(rnrna P 'tl"ie~o era~or ~Qr~'orwted sor•-rP~lark ~o ~rrec'~'~~e
<br />c~ra(aage u y~re~. ~~- shoe Prle, as rt~ueS~e,d rn ~G.2 $4 f~cper~I,~~,P
<br />Wor !c cJCs /u~ sa ~(s ~ac dory hvw e./~e.c' a.r d-rSGloulc~ be.. f e done. ~a ensures
<br />fi~Q'{' -F~.Q ~a(neS GKICG; clrar.t~G ~ c~o~.5 n.Or COn~uc-~ f-~osp 5'~c~Gflf~e5,
<br />'rG~'~~{ne p rosPec-~ rs ftlJ an a~Ca ~"~.a'~ wro or r-ray not ~c r,. {-~,C.
<br />Pe,rn~(~- cc,ren Tl1e o era~r ~aS also s~~ored CG
<br />P (~ ~ rrOn~- on~crY 3allarcl
<br />Son-re ore brn5 rn ~FH;S c~.rea„ T ne
<br />~c~~DI ~.a5 (ndrea~od- f4.a~- +G„rs P~~risei-o IS415' Y.a~ Frec~~.
<br />be ~;I,yed as R Porgy( ~' c- `f-G~e.~r~~. #2d Y ~
<br />ro50ect
<br />Tfn nac'eq, be~.~.~eevt ~~e°~t~iKr~1c sl.,~~{- and~a~ls {{acs Teas 7704
<br />a.~d fie odd scene ~urll ruln5 ~.~I rll nerd ~I-o ~ 4
<br />b¢_ rncorp~ o('cti-cd (~'Eo -(tie cr~»,y- threK '1-L.~
<br />_-0.moA4Lwiaw{- (gel-~re~ ~~ro~a orK;S
<br />----~-~ p r0 CESS G(~
<br />Sri.. Q-
<br />I ~ E Contact Address
<br />c: ^
<br />CE I
<br />Nar0~6 L uz.ar S~
<br />
<br />NAME ~^ rc~c eQC.e
<br />N
<br />4
<br />I
<br />G
<br />n
<br />e~
<br />D
<br />f
<br />r o
<br />^ Hw
<br />HMW6ID (CH1 D~ran~o Gop
<br />~ 0 ~ 3d
<br />;
<br />4t
<br />.
<br />M
<br />.
<br />LQ
<br />e%.
<br />OPERATOR /~
<br />//~'',
<br />Ig
<br />]
<br />~
<br />STREET r17. QOX ~l0 ^ WQCD (CH)
<br />J • / ~7
<br />F //V/ 4/~j ©~
<br />CITY/STATE/ZIP
<br />j0
<br />OTHER
<br />
|