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• (PAGE 2) • <br />MINE ID # OR PROSPECTING ID #: /'~ ~ U ~ ~ 7 `~ <br />INSPECTION DATE ~~ ~~ ' % L INSPECTOR'S INITIALS <br />OBSE/R~VATIONS ~G~K"~ ~~ <br />~Gr e EX/ 5 ~/ KS h O n o~ O -~ ~N `TddO / 5 ~ ~ ~'L <br />a <br />y a C ~'P5 r-~G J or ~ s ~v r ~ ct.rt cP <br /> <br />Gl~°P rdn <br />~ ~.e <br />ZO GtG~'QS <br />S~Z1e <br />~ ~ ~N G ~a vµ~. ~ o~- <br />.~ 3D, 6zo. o0 <br />r 7acr~5 r~i,~a/' <br />GW e v n ct ~i~ ,-.~rAJ o ~r p(,g ~viph~ v~c.~ <br />Z ~ C~ C. )C ~ / S3~C. ~~lC-~~- rK i K GG~ z~c~ <br />Gos ~ G/~u r, vc]! ~ Plvvr r tai.-~c~ ~ ro c ~ 55 <br />r'C~cj U/ r °r/' ~ r r~°G (/Ct n~G~Ti 0~-~-~ <br />/ is 5 i <br />5 U r Z Gt ~ /P ~, /~ rc ~ c~ ro vv ~-r .~-~ ~°G~~ v.~ ~°v~ co v v~~~ <br />- e4~ <br />dvr, ~S Pxca,~o~ z~io-~-~ /'NVS~ 6e Q <br />S~DG~~/~2(~ <br />~LSI~ r~~p~ -~a~r- <br />~ r~G-/avv~Gc.~io-n 7l2~ a~ e.-a z~o.~ /tea s <br />~p <br />CD H'~ .vr i Z rP /G~ c.Q ~ " ~ 7 ~~ <br />/~ <br />~~ <br />Ov~i/ ~vr~eK <br />Gtr~DC ~a~ s of ~l .~er- roc /a ~-•-roc~~-.-~ <br />/v "J e/1C'~G~IZCP S/~ /e/~O` /JO(//t4~G~'~'y /Y~OCrK C./5 ~ ~P~rl/i' <br />I & E Contact Address cc: <br />NAME <br />OPERATOR <br />STREET <br />CITY/STATE/ZIP <br />M:MIN\OSS\ERN\INSPECTI <br />(10/92) <br />