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• (P/age ^~~ S • <br />MINE ID # OR PROSPECTING ID # ~7_ 90 ~ ~T 7 <br />INSPECTION DATE ~ 9 ~ INSPECTOR'S INITIALS <br />pp~~ OBSERVA~T~I7ON~S J/ ~~ /' <br />`Cl ~- //CFI+'~CC//M ~-A-Y~/' ~ ~~vlKlOt1zi ~, 'pm~a (S~ !~/ S'r~~g~a-CYQ,~~v"`0'..~/~-/~ i <br />~2-~w~ 7t~L. ~~JOl/~ /~ 4.'~( l~v~'~/~ Q1Y2GYS Gf~A-~ 6tx QAw~aC~ <br />/~w;~ ~ ~l,,e_ l2ofYl~ 4l~.~ {Z c CQw,..fo,. ~1.~c- cud-o. no uit~.cf <br />Ll.,.,, ~,s~ a.~- ~G,.e -~ ~n.t, l~ ~Y~.,ea...~ ~i,~ _ .S-~n,-,-.,wa~w" l~-a- .¢.o~Ge4P <br />~i~ ~/~ / 'f~ ~Z.Q aka oCr. us~ ~ rack . ~ ~/~~' <br />~I'2a`na ~ ~~'s`~'l~ !U^_~- ~L.rc /~-fn-e o~ ~L,,c GL~~ r ~'`^~' ~ ~la,..re.t <br />p"~cCl~-o~~~F- cL~cr7 I /f/0~lxol' Q-~-~JGr oE'et.c~.~,1 cz S/o~-L~ ev:eecfua~c <br />/~T o C~-~a..I' Ci4.¢~' / Yt.L Of}C,~-O~W G/~-~ /"2~ ~ ~ C! [~YtJ(L~'v~/ ~f~f <br />Qra,vr<a.~ ~ rtin ~ 7(~- ~Lvutro{r~ dc~wr0 o~c ~G..e stye <br />Q~.v, c-Fe,~~ n G~u-F l/~r ~.pa_cl~ ~Le~s~ Cti ~'c.. ~/ ~~~"' ~~j"'~d1,~1~~e i <br />"t"'71 e s ~-~ rX Csv(.s~ ~ a Sn~a.~,Q Ca.~c~.r~.¢.,~v,.<//,$ r Cer1~-f /~~'~O~ Q~ <br />v`ltf._ i"~ TG~ aC„OC.-FD ~Y/N NNr ~ I~GC11ri/a"~ ~G,,c.~F GG,lTl7r~.c~ L~ C <br />L~~ ,¢~~.2e~ by~/j~ ®7l-0/ ~l~"•.~,.~(..Qt., {Z,z /'/`4'J~`'al~.ee~•-y~.~6((~f `~P~~7~t {~ <br />pL {~((/lJ~~,»7~-~ Ga~.YJC'A 4.r[ G~r'/Yio /.~~n~ 1A ,8'17 ~T+'owt RHO Qc vj.~n <br />- (VI '/G/~~ ~ViSctn-~ ,QkGVrvwrtQaC ~/ CF/LC'c~ ~c-C~OZ`e ~"`R- a/~~~/~ <br />Gr(J YOGIC. ~ Cw~1-cW !S Covi.S~LrL~ZC•[ t llin- F~Mrrr~c <br />! / <br />/42~ Dti~..c~ ~a.'tit .~ ~+P v„ sfi~.,Ct- ~H . !~x'r`Gt"P'ct' <br />Gv-b.~- ~w,~~er cea.e~- 1 <br />'fj,.,2. f'N~-C,~ kx.s-c1 ~ ~ /ww.a a y~ urti„v~+j~.~~c~~ Yl.~ lm.~{t~caC-e- <br />G2/v.eQ 1.+ -~7i ~ G '{~,~1' /~Q 2.U~tCsf . /rnA.e tD~iQ t~-~//, <br />r.S loC~~~:.,Lit' Oyl ~LvE- S'IR.QO LI.~CISCaCF. '~1-Q~jiVV.it L7-GtI.[-._- .c...l~~. ~(IrQ~ gJ[Rs++~ <br />/.l.v'•v~//~~p(+-''+ ~ ~VV~ u~¢ rve~ ~„Cl~,i 6r/t tefj~ fG,R ~ G.DI.,.{A/ ! (A!'{'1.[ (L~ <br />C~~ ~ V%S [g:, QY~ap.,rr,,l,/>ti.L~C ~. C W~c s r.2~..c1' ~ ~ ~`'`. <br />6v`E'v~c,e~ fneRC.at~ 5 ~V~~.+~C /~ e c, ~2 .Smv~ 5 der <br />~2vnC ~~~ ~'~_ ~Li,.,p (fu t-EorlCa-l~ awe/a ~n~ ~ scree <br />p~,c,r~ a/1,Qo~ . ~,.~.~L 1t~.2 a_/ v1/S9vJ- /Lft/4'~~. ~aiSY±npn.~-tom &y ~~-e--rr~ <br />p/~-r/a:~o_,r'I./~ ~a..-g2 ~aAf~rc~wQ--,,~{~/'f~ ]~(.1Z G~r.~..-.~~ r'v~a~acf%'y,/(/~Jr S ~ /LNV~/d~ G' <br />/!r0/1- j',^"^~dC d~•./ "(,L LY /~.y I (.L.LG YO~ (~.~ r~CV't y V ~ ~ `T(/~L LG_ <br />2 ~ E Contact .Address ,] / / • cc: ^ CE <br />^ BL <br />NAME ^ FS <br />^ HW <br />OPERATOR ^ HMWhID (CH) <br />^ SE <br />STREET ^ WQCD (CH) <br />^ OTHER <br />CITY/STATE/ZIP <br />