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<br />~^ GG /(Page 2) <br />MINE ID # OR PROSPECTING ID #/d/ O ~' ~~ 7 <br />INSPECTION DATE /:~ -/y- 9 Y <br /> <br />INSPECTOR'S INITIALS I~ ~S <br />,~ -~-1,,,,0 ~,,,A,~,-~~z.,. <br />~ ~~~ <br />3.; ~.-'t-9 -~^.a", ,r-1~ ,n.u~..Q. C1 C.u~ ~.cw. (x,e~-.. ~~ .~i~o+w -N~ af.~.ao-~~--~ ~~ <br />-v~- ~-a~.~~ o-~-e~~ ~n ~-t~.a' ~;,1, . ru ~ :ia c~~ ~~..-., 3 s" ~ to -l-r-R <br />~ A '°.`°~^ ~ +-~ fie, -~ .~-,:.~. ,o.~~- u, ~ ~ ~+- .~-•~.,.~ e~~.dz <br />.M a-~cP ~- lJM C- l`~ -~ hum-Gee- 5-~- ~-~e 3 s~'/'fi'>~ ~t~-o~ <br />~~ ~ , ~ - S-rte -~ Ma.,,~.~ A ~ ,~ ~ p ~ G- <br /> ~ 4 GJ a~a.~ ~~ f3scr.,,r/~ <br />` <br />I & E Contact Address cc: ^ CE ,r,,,y <br />~ <br />NAME InJ r ~. Po~..x~,- lUd Sju-..-~n~ C.~ ++.Zv~ ^ HW R k t''~ Cdr SD 7 <br />~ ~ <br /> <br />OPERATOR <br />.t1 0~~. <br />.~.~ <br />Ce-r-....~.<r. <br />~ <br />^ <br />HMWNID 0 <br />- <br />(CH <br />~rlrtr;c K, <br />$ C <br />" <br />' <br />~ <br />~ ^ <br />,, <br />99 <br />/{ <br />~Q <br />~ <br />1~ <br />' ~ ~ <br />/- <br />n <br />~ l <br />~ <br />~ <br />_ <br />~6 ~s~0~/ ~"^'~~w'or ~v4 <br />STREET it <br />i <br />0 .~ <br />//~~ ^^ <br />p ^ <br />~'( WQCD <br />OTHER (CH) ' <br />l1 ~r ~ck 35~ <br />,, <br />..`` <br />CITY/STATE/ZIP /7k~C~' p(~7~U L(LySS2S,KM"SY~S <br />