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• (Page 2) • <br />~ MINE ID # OR PROSPECTING I-D1 #: (Y~ -G~~ ~~- <br />INSPECTION DATE: ~ -' a (v ~- ~ t INSPECTOR'S INITIALS:~~ <br />OBSERVATIONS <br />~ i~t ~ .~ ~.t t s t a N ~ -~t.D u,c,Tc~ I m o ni t ~!/i N~ ~S p r~-~ t o tV D t' <br />~~ S~~C oiv ~}-ab-~t`~• 22~t=~aT ~t~~~~~ -Hn~..~us~~T~o~- <br />~~~~, m~~ sc~ rt c.~~ls, m~~ ~~-ttL afl~rves f~+v.~ m t5s v t~~wl~ <br />Nom. rn M ti ~v`Rp~Sr- o ~ ~ ~ ~`T. 1S~tZT-~-J ~l ~S }0 5 ~~ <br />~t/ ~a~rCL-~~S o F stn t C~~M2.~niG oQ+1Z~}-{ oN, Tl ~IZ~~S <br />l~p2e~l~ ~-~Dt/~ A-m~:brvl~~i-~1 <br />TNi~ ~s~~-~~nc ~a~~. 3y w~~~, ~v U i o +~~ t i,.~ ~t s ~~ C <br />-A ~ ~! ~S I O j~ s-t-u. ~ -k ~ ~-e P~~L~ r~lG ttn C ~H P~ E ~ G. t~ctt p tt-~ ~t~ <br />~ ~2re~F,p ise~-e-S~t~~, WA-~ {-ItY,D 1k~bae~fi' 7Fh ctC 'ld`~ ~m <br />'1`h~ 1 ~ Ptt~.}- ©1 '1-h'~' .~ I y E`P.51©-~ ~yc-tom, r S c ~ n1 "l o f~2 ~.1.1•ft ~/~~ <br />t9~n t-t o ~ -b p t? a ~~r~~ ~ tt,, t~z-fi 1~ ~ t~ ~-t" Lam- ~=tz~ nrt ~._~ S t owls <br />~ • TIC sp~z t ~ t~ ~ 6~+~.~' o F t~ ~: Cu. c. ~l~j .~-+~~ <br />~~~2-~K~fio 2 rt A-D cA nl •U v c_-f~ ~oc~-1'(~.l e M R-~ ~.!-htt TC k-~' C.C Pro ~ n! .D i-~+ C i <br />~13'R ~ C-ft-o~~ on1A-C. ~~~ e,~suSr~ b~ 5 ~~.1~-c.6 ~~a1-~ <br />~.oM h-bo~~ ~-tn~ Ova-LtsT A-R-t~'i 1-~~-~t.~ Q~~1 i3fief~-fiC,(_t?D <br />~ c~ i m ~~ T ~rvt <br />-1-vt ~ P ~/~I.D ~"o L~.A ~ ~ a F -+1~ <br />~fiL Esf }-{ {K b ~ _ ~~ ~~ ~ fn f~- R-~ld GAD Cfip t`t- t,i 1 ~{ . <br />~ • • ~ Fb l_l.o u~ r ~ U- (Z, h`YS~ 1 ~ G-,S ll~ 't.U I~,r=SZ- O ~ t~ FQ p rN }1/1 ~ ,.. b t~ <br />~oc_.u r/i ~ ~ I~ r o-H ~lot/~ m c c_.ot~~zTr ~N S ~-' <br />' ySt~n1 ~ ~I~/1-5~:ll <br />~ o~,J ~ <br />,~ 0 L ~M C (' U r~ P ~# I 4- ~,~~`"'~a mQ ~ l ~ k S oFF rat-}b, e <br />$~a t ~ .1 -firnne o~ -1-Inc i'rtsQ~sz.1'(onl- <br />~ c-o~ m-e-f-~ rn ~-s~.~.~.~D ttP P X a • I ~j P rn • F "~ t~,J ~-~ ~ ~,J „ne }~ ~ r~ <br />I & E Contact Address <br />NAME: cc ^ CE <br />^ BL <br />OPERATOR: ^ FS <br />^ HW <br />STREET: ^ HMWMD (CH) <br />^ SE <br />^ WQCD (CH) <br />CITY/STATE/ZIP: ^ OTHER <br />