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(Page 2) <br />MINE ID # OR PROSPECTING ID #: {l~J i0 /~~, <br />INSPECTION DATE: ~/-/J, - ~7 INSPECTOR'S INITIALS: ~7 t~S <br />OBSERVATIONS <br />1 ~ /,J c~ t.C~c.u-(' ,~/ c, ,~i. 1'.~'_ ..~i. (/L,.:`I~ Gu:.,O n-L 6~'' s r/ "'~. <br />(~.~.(~ ~ ~.(,o IiWJ~Jr~'`~'" r c'l !Lt"'...Jc l l7 f-~-M (/~ y^.a~-~ ~, ~'/Gtif <br />1J 0 / <br />+~ / <br />;~ <br /> <br />I & E Contact Address <br />NAME: ~, ~'.y S ~~~~ <br />OPERATOR:~• ' <br />f -~ <br />CITY/STATE/ZIP: Nc~/-/ n /ce_ C.(~. r~'b %3 S! <br />-~,.-T <br /> <br />cr. ^ CE <br />^ BL <br />^ FS <br />^ HW <br />^ HMWMD (CH) <br />^ SE <br />^ WQCD (CH) <br />^ OTHER <br />