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(Page 2) g <br />MINE ID # OR PROSPECTINGhID # ~-?]-?jr7 `` <br />INSPECTION DATE =~al-`~ INSPECTOR'S INITIALS ~+Gy <br />OBSBRVATIONS <br />~ ~ <br />w~n~+at~ ~~,t u.ae, ~c ~ S~.d,cQ ~ ~ ~ <br />a~~ psi i~r~~, ~qg~, (q~~, ~ ~qo an.e atEae~a~~ ~~ <br />C~-(~~ut~lnv~n~ oeC¢rc. ruil~~.~p ~utcunA. ~ ~r ~~ ~~~ na <br />~C~P ~'~t.Gti,lH.l'~I~c~, t~ ~+Qw li~~~ -~~ ~-.P.~t,, ~e-pea~,ct au.~ err r~ <br />~ p~~ta~r. <br />~~~~P.~.~~t~c'Qti+~~,~~awoul~c~ ~-q~,~+,t~,p ~cl~ eu~~ <br />~tG~ ~~ r~, ~ ant (~n~ ~ o~, ~ u~~ GF <br />`~~ c ~ (L~¢,~~,~'avlr~ c~17~2 ~c-riu~ ,~r Di~~ein ~' ~~~ia <br />pt~a ~~~ ~u;, a ~e~~ mowed <br />C~nUet~,c~1~c~~~tcf~ f I~ ~mu,$ ~t a i'~ I,~ u~tu~ <br />~ ~ InITuQt,~, ~Ct~~~'!~r LUia11G~~ {z ~~c~ etC~~.r~~ ~[0 Acct r Gu~~fit~ c~ ~Gn `~(~ <br />~,~~t`CUc a~~~l~ ~, :~ c~i~ G~'-~Qc~c~~ ~ exec ~ P~c~-~m eat <br />~v-~r,~ ~~ ~rim0uf (t~tiu~~c ~~ ~-~~.~~, o~~.w~ atoa U~~, u <br />-tm.~~t~ ~Z~it~ cU~a. ~.~~p~,~cDU~f~'u~~.~ r~~er~~+~Mc~ , <br />ck ~l,,~o~ ~m~cul, C~,u ~PCd~n ~~ Dr~%~,t ~ ~~ ~ <br />~-~ e ~~ ~. <br />I 6 E C071tdCt Add~'aae <br />CC: ^ CE <br />NAME ~~~ ~~~Rf C r t.Ut~(`~ ^ BL <br />OPERATOR SuNHIT ~3(ZI~IC~CiJD ItCL- (~. o ~ HR.PUC~~P~ltRNHA~i <br />STREET l3~' ~ ~Rt~ o Sx~wMn ccx) 1(2 (~, 13n. ~y+.. <br />CITY/STATE/ZIP PUE~3L0 ~ ~® g ~~~ ~ DER <br />CER IFIED ILII Z 416 942 612 <br />RETU RECEIPT RRnrTFeTCn <br />