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;. <br />• (Page 2) • <br />MINEID # OR PROSPECTING ID #: (~- - <br />,INSPECTION DATE: ~ ~ ~~ ~ ~ INSPECTOR'S INITIALS:_.~ <br />OBSERVATIONS <br />~n ~ ! ~fi , f~ue.-ti~ '~E~-t- S l fl L c~ ~ 1-In C "~~.n1 ~ 1 ~-t£~r • ~ ~Nft+l~~ <br />51 ~ u1 tt-S l,J R'C,K ~ ~ ~lS P ~-I~ t~l D r'11 IFJ D (Z 'Q Q t~ to l.~l~'1 N t~}~ <br />~~M l j SIG 1~f uJ R- S ~ ~o ~ ~sR- ~ `~ ~ d ~-r-t~D . <br />I & E Contact ,Apdd~ress 1_/ <br />OPERATOR: _-(~ C O /SI C ~-CSZ(= <br />sTREET:~~~~ "R_~s12 Ole! E- <br />CITY/STATE/ZIP:_t-/ (~2~~~'/~/~ ~~~~1 ~~r'~j <br />cc CE~~ <br />~BL <br />^ FS <br />^ HW <br />^ HMWMD (CH) <br />^ SE <br />^ WQCD (CH) <br />^ OTHER <br />S~"~ <br />