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(Page 2) <br />MINE ID # OR PROSPfiCTING ID # M-4~l1~'~y-~ <br />INSPECTION DATE ~~ ~I(~ ~ 9 6 INSPECTOR'S INITIALS <br />OHSBRVATIONS <br />I~~~`^r'..~.-i.~n c-e~v~,u.,~,'~-¢~ c~~.s~•tn~ -}~'w~Q d..~-u..~.v~ ~c~ '~~~~n, I, <br />"i^'`~~-~•6~n ~ ~ P h.u~ ~ anAU e-v~ 8 ~ ~ o (9 6 . ~.+..~n-w~~` d <br />~-.~-k.~,„ ~,,rc.nA -~ ~ ~~ ~ ca.~ do.Mn~.~ ~ ~ e-~n ~ o ~n,~ ~ Cc , ~ ~- <br />~ ~~ o.~n ~ R~.~Q~ ~~n-~~t ~ c~~ -tom ~g,~ ~~-Ee~ <br />~..~a,v,n,Q,,,q,~ wtQQ rn ~~ 6-cc.~.~~1., <br />~~ Q k ~ cZi C w~n~. ~ ANV~kA ~~~,o ~rv.A j~ntn-t~v~~- ~ i -~ ~.c~ <br />~ inn c_c.1Tt~ w~ -~ ~ <br />e~-c9.cS:.i-~-~w~n ~ a ~ (tic ~ ~.tiQ <br />I 6 E Contact,_.A~ddp~r <br />NAME M ~ I/)Ll, <br />OPfiRATOR l ~_ z ~l0.ll ~/ /; <br />STREET _~ ~\~I ~ '7-~{~~ /~ I `7 /I~ {~ /` <br />CITY/STATE/ZIP V ~ C I (/ ~. le~ ~C7 t'J•17~~ <br />cc: o cs <br />O BL <br />O FS <br />O HW <br />O HMWMD (CH) <br />O S6 <br />O WQCD (CH) <br />O OTH@R <br />