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3 ~ ~, ~ <br />p (PAGE ®) <br />MINE ID # OR PROSPECTING ID #: M - /O ~ ~~~ <br />INSPECTION DATE _ 3/~ /~T ~{' INSPECTOR'S INITIALS ~GL, <br />OBSERVATIONS ~- <br />~d(1XLu ~~~,d.~.~.~ ~cL~.(%' f A.~L~ ct~s'~tA~ /l.lU2 ~L, ~•~2.4ti C%~e.ti, ~~i,/L <br />GtJei.(~/ Gw(.E /A~a-cG, TH.~ /c'+~"e/i/au.Z cv+si~.~. ~~~~w~u~/y <br />et.w•Q Yuri ~ ~~~' ~n~t <br />/5 0 ~a~G ,ryfinn ---~ -~/a~-2~^t^,,^,~S~S ,yh Gam: (rtI.-.•, ~ ~ ~zvt ~ ~ ~/ i'iL~ ~ r~y~M <br />CXCR~I~ ~` ~ ~~ ~f ~fti CT4'N (/ ~y i <br />Gciw`~-~ - ~, ~°~`~" ~ ~ a -f e eG,u ~...~ re yr &t.~%. 4L.x <br />~n ~;v,scv,-• <br />(yYL G/2' T~ ~'+-cJ ~ C~-6L !/n.~N~c / ~F'~.PY <br />`" tY Y~. IG rte` [C; I7 rL~l. tl' _ _ CPM.-~7'~~l G'~L ~ ', ~ Cfl~•Y <br />~ n CI t.,~ ~i7r ~:i,~ c c~X I~2.Yl tz'r~'~ ~ ,j <br />q IiLNi~N.Y /I`L?B..C-~t/~,t''1-- W;/''~ ~i2.. `7~~te.v~ /U / . i <br />p.e CD~R,~+'u,`~tzK ~^^^~ ,~y~¢.-a.{v. /oCa„~-- ?4, /h.a•~ce• '1v r,R~,f-i / <br />~~ 6-e-. d~v~~ ~ ~ ~~~ <br />i <br />I b E Contact Address <br />NAME <br />OPERATOR <br />STREET <br />crrr/SrarE:/zty <br />5~a9F <br />CC' <br />