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(Page 2) • <br />MINE iD # OR PROSPECTING ID #:~ -~Q3 <br />-INSPECTION DATE: ~-Z~f 'I OC7 INSPECTOR'S INITIALS: <br />OBSERVATIONS <br />TGaef W1af ~ ~H-ok r p~r~ r~f~C~~.-~-/ tO -~i~ con-~ l ~~/~~ ~.~. e2~. ~~ <br />~oer~-r! a~r~~,,u•tai ~ 1. f'l~~z~G~/?/~~e~ ~~(" l-ortrr ~~e~ <br />~~°ou.-~a~~~.~e <br />~~ f sl~~ `waJ ja- ~ 1~_y1/~~C~~J br /Gce j7rv~f~s~ eu /'-/7-Q`~ <br />G/a~ are~`~~ I~ «~ lc.t_L b~f"~.~,-~ ~ rda~ $'[~„, ~a~ f~~c~e <br />>+~~ Q~~~ <br />~/ ~L-~ ~" <br />~~ s~~y sG ~~~ -~~o~ d ~~/~® <br />~ 1 u/r~o`~'-cC <br />a~ ~~ wire . ~ ~I f~ 1~~wL~ ~ ~ f L <br />~~ p ~ ~ sTroc o7 ~v2 ~Gt~.~s ~o e r-w ~ `l <br />w~~« ~G f ~ ~ ~~ ` ~~[L <br />// Q I a I" e f~Lb' d~ a l~l ~~~~-' <br />waf o d Tarvc <br />f. r~ ~~~~~~ -~~~~~ <br />~s7`~66,.;~ce~ cry rref~ <~ ~~ fsy.~ ~~~~~"'.~~ <br />w a f ~a~ .; U -~~ ~~-~- l u-etc, <br />e <br />I & E Contact A s~~~ ~~ ~ } }~ h ~'}/ 7 <br />NAME: M l7 ~ ~ "' ~~ ` cc:~^ CL <br />^ BL <br />OPERATOR: ^ FS <br />^ HW <br />STREET: ~ ^ HMWMD (CH) <br />CITY/STATE2IP: Z ^ WQCD (CH) ~ <br />L~OTHER <br />T~ SttL~~t -D/~G- <br />