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f • (Page 2) • <br />MINE ID # OR PROSPECTING ID(#~: ~ / a ~ <br />INSPECTION DATE: ' /~ ' ~d INSPECTOR'S INITIALS: <br />OBSERVATIONS <br />rl~ <br />// r .e~.~ <br />~ ~-~°-~ ~- ~ ~ co-~:e, -/~.~~. „~ Gam-,-~ ti:~;~.,~.~~a..,,.~1 <br /> <br />~..~ ~/ <br />r <br /> <br />I & E Contact Address <br />NAME: ~ ~. _ <br />OPERATOR: ~ „r_,_,X C.c~.,,_,.,~1p~.o,~Y `~~r~ <br />STREET: y(y ~% L: ~ T01°a v / ~ /go k 9 <br />CITY/STATE/ZIP: ~~e-,i ~i •/ , (~(.) • ~`t5 ~f ~ ~.o <br />cc: ^ CE <br />^ BL <br />^ FS <br />^ HW <br />^ HMWMD (CH) <br />^ WQCD (CH) <br />^ OTHER <br />