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~~ <br />~ pp (P,a(g~e 2) <br />MINE ID # OR PROSPECTING ID # ~ ~("J O'' ~ ~t' C~ <br />INSPECTION DATE ~ r ~. ~ ~q ~ INSPECTOR'S INITIALS <br />OBSERVATIONS <br />W ~3C~ln ~-0 _ nM,~~~~lL, <br /> <br />I & E Contact Address <br />OPERATOR ~ ~ ~ V l Y V <br />STREET P ~O /• ~~I~~~x ~~ (('~ ~' <br />CITY/STATE/ZZP V ~ C~.1 1~1 ~ ~(') ~ <br />~C: ~ CE CktZl. M Ov I~tT <br />^ BL <br />^ FS <br />^ HW <br />^ HMWM D (CH) <br />^ SE <br />^ WQCD (CH) <br />^ OTHER <br />