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~ , ' ~N (Page 2) • <br />MINE ID # OR PROS/PE'CTING ID #/` ~S -G3O /~ <br />INSPECTION DATE ~-(- ~ 9 `~ 9 ~ INSPECTOR'S INITIALS C>" <br />OBSERVATIONS <br />• ~ ,~,,~ N,.,,O, 0. ~,. Q,,,Iw.N,/( ,s,H~,„.vLG.,G C ~O'~L.-, /~~~..~4.d,..:./ ) ~-.-•; <br />/~ - ~--~ ~-~--.^' e,r.,,.p/(/~ 'U;!/LU".~-~ ~-~-.-~ IN~JJ OVA ~--~'~'tIC- , <br />'F1.~,~^~+-~0-~ io ~-.;,e r-1.~ p,~.a-~~ea. .~ ~/~y ~x.~-fie <br />~ ~ ~`p.~.v-~.~e.d ~..! /~n.a ~.-a.a.-G-Q~t- ..~:.,,u..a-!.u_s-uy.4,~r~ 0~~-+ ~ ~. <br />~' ~ 0 ° ' <br />c~-~rv'~v~"c- <br />I & E Contact Address cc: ^ CE <br />//++ ^ BL <br />NAME .1 e~rrun l9 Y-~-~n ^ FS <br /> ^ HW <br />OPERATOR le v ~, ~~ ~ ^ HMWMD (CH) <br />p <br />STREET ~ /yy~ 1~i ~~,~sv-- ~ <br />~~ <br />'k 3`1" <br />~ <br />Oi ks G ^ <br />O ^ SE <br />WQCD (CH) <br />6 <br />I~ <br />F <br />~ 1~ <br />( <br />~ <br />/ Q ~ <br />~ ^ OTHER <br /> <br />~~ <br />CITY/STATE/ZIP <br />_ 7 <br />~ <br />d ~1 <br />~+~ <br />