|
~,. (Page 2) eRri .,.
<br />MINE ID # OR PROSPECTING ID #: ~ ~•-7~-Cp5
<br />INSPECTION DATE: ~- ~--I-~i~~'r INSPECTOR'S INITIALS:
<br />OBSERVATIONS
<br />Gc~-cPt-zT'e.i~ 1+- Pte-e~e.[,2.Gr-rzcv [a;SPec:'rrow ~ 7ef[S stz~e. ~4S
<br />/'.e.~a I a~~ r,~ Rule 3,a C7~,
<br />CU.(12~..e.T7'iY~ Tr^~-rS i S /i r 3b4 f~C'/24.. 2'w' t.l L~2 [ia F¢2t-!! i LtC/4T~i~
<br />APP1Lokrt7eV-7'¢cy g 1-rJ~es s~cu.Tbic~e,sE- aF ~,~c.e-~~~; caz ~-,c~ c,~:es[~
<br />S i ~ Q o~ 5 o~f~cAresz.~ Rory-A,
<br />14-¢ PZ2M ~ ~ T`2e. ['rye 1052 s TD ~ x (~,~jT~ ~ !+e P~eRr-I!'7' ~/1~~- j~
<br />liv`~~ At`.fZeS (3~.7 RC.22 ~f'/~J~uiC'.LT~.
<br />N(e'T' 1~:,6T6-E t'[1L< NI i C.H/{eC. i`c.b~2,p~ ppeR/1-'fcR S iQ~.,f'keS~+.lY7q-~r [U•{' ~
<br />I N GA-(. i-1 F} ~ `+ 31-2-rte A 2c~-v 2 `rcz T[4-e •~r c ~~ 5 c Te , f~' <~~ 22. fJ r 742
<br />[.So2T'r~ ~z~N2iT' F~-Re-/f 62rs A~ ti3ew-t.~ CesasSi-~.u.~7~e.~ D/R.T
<br />/-~Ccst-5S l2cf+-a, i 1~- 2c.Q-A r5 F+PPROkr[-t.~7z2~y ~0 t^~~z.T c,Jlbe iP~C;[J
<br />f}(~o~.tT' i.Z~ i-~e.T' C~a3t~. 'rye. ~2cA-~ l5 ttSeA r~ s~Ce~zS~ R~
<br />Leo `iG''R O F C~~A~Y i rv 7LFQ w-~.-fi't'- lf-~t-c.F c~ f= 5 er~-TZ cxS l-(o _T ICJ - RC ~ cam:,
<br />i lam- CC.dk4~ ~-~'~R-f2 { 5 avre2C.l4-[cJ /3~t .ie~ePq-L ~'e.2,T a-e~ 6RCSU:"TZ~f
<br />t-rebtr-l,n ~~t~ c-v~le.C~[.t/21>e~.9 athrc+~-E [s sri2[P~b cse~f' f'2[erz 7C
<br />i1xC~-(Ti4-TZa76 -rue. c.~q.~ ~.e,Po~~T, ~1iec~i~.)~• rs P2oE2esstti~ f~'/~'~7
<br />S~x~r4 'TG >,SOEZ`~F. D U,F. ,•'-b zK.~'2¢.r-[~i.`! ~.--e,'i- c~G ~cTlJt iZco3 S. ire
<br />I{-r-r c~ ~--+~" a~ i~ c5'IU24A-~~e usR-S .v oT De~~.,rcta; ep , i T I S
<br />1 rr (rc-R"I~~ To ~z~/'1*-te~'e i~`lPrt. /l [S`Z~t 2(3~-rJ~e s?-7- `r~F<5 ~t`[~
<br />S [ n$~T,e i Z-ftS [s ~ PhF~-sfz~1 H/Jlt~7U6 ~ RecL+9-~lq-,~tci~ cY~c'~2./~-7GOn1
<br />u: G~Q.R-e. ice. [?~[ trvu h7 J$PP2~cU~ Q [ 3 ,• u2r3q,~*,Q„ !~ Sb ,4etP2c S
<br />(. 3 5' ~.e. S tt~4J cft ~ r ~' A~2e,5 tK d ~eeq-~ ~ ~ru>`o,Q. J, ~R , ~ ~ Q ~ /Z
<br />Sta-l ~ •raae. a r s^r c1. /1 ~ ~2.7~ y9.2e~t-5 c..= c µ ~ D F3 ~ s u,;eJe.Y~ ~ro ~z-'q,~R.rte~tE.
<br />~~ [~-~ tJ l 5 -r-u, rzl~~-.v e.e ~4-•r ~i s s t r~ , ~ r-f c s c~: [ irc. ~ e ,~-oTp. ~ ,4 S
<br />f[4- P2a1.iee.e`t az•3 Pie 3 aF 7Zfr.S RePoR`t `~ t-F~ ccrz.eru.T! cl~e
<br />q-c.-~eoe~ ~ue~. Ar}~ /~ r7~Y 3~, ig`t9, "~f15 [s ~voT~.~v ~t-S ~
<br />P2oCi~=+-1 >3a-~~i-u Se ~e aPe2t}-~-tt~ RKPoRY'~l~ G 3~:2 A~CReS
<br />~ f= b t S Tit -e~ll-rs ~ r f~ T!f e i q 9 8 A eVn1[.~ q-C~ R e. PC?R (, ! ~ E~e~VLl2.rze
<br />j Flt oP-e.Rs4-Y't~2 ~t.CGe~Lp2a 'r'fd~ /f-PP,~'cV~2,p K,¢Xt[`LU.N RLGcc.~''e~,
<br />p l 5"u!i-/~A-tas~~
<br />~c"rl•e [.~cF~-c•F-r /-~-c.CraS S 2o~i-D, AS tio7~ ~ ~/3~e, l s Nc'r r+.~[.tTtotvEb
<br />t~.S ~ka-~ l4f3'S CISA+JU-/t-5GOtil (a•ryf~,'~6.YgsJ L~/~-lt Cr`rc1e.2 Rue~[~$
<br />Goeus7nua.T^eA !`oR 1'Y[~3t~lr; nwzPoseS W-JC.L /3e Rzet_gt~-Ce,p_.,.~5 e2
<br />1N rFi-[S Ac-tQ.vtJh-[~v~i l4f'~'~.i fix}-TrGD~7_ TF4~ /~~~D (S n;C7 SGt.c-w«l
<br />r~..w~gt3rq~~3`J1 aim Tt-l~ cz Kl-r-[(i[T /`[L4F-1S, StiJ~¢. '~1c; 21 cld-P r s ~a~.TS/4eRe~
<br />I & E Contact RddressC 2 D I~TLt F2 f3t~ <~1 ~sR e i 7' /-'f riS`T-• 134? /JQ'fi2A JIM ST~I?~i.T$
<br />NAME: It'r I CI}!{~C. L L' I D 1 c.r~- cc: ^ CE •
<br />OPERATOR: f31[J5C713 ~ /~ r L' /< `.CS ~~~` ~'~"~'!~'~~ ^ 65
<br />STREET: jQ45 (J~ -T~t''(CS(.f-~I ~~ ~ grN. r'LGOl2
<br />13 r 3 SC..a-1Z`1 F1-~c1 ^
<br />o HW `
<br />EMWMD (CH)
<br />rr''n~
<br />CITY/STATE/ZIP: ~d.St)IE~ ~p g(3~(C- Ian
<br />-' b'Z~3JQ.r? C.~~,
<br />7 ~ S
<br />WQCD(CH)
<br />
<br />c~Tl~l~o r~;nt~~ No. ~Z~13U
<br />qu I ~~3~03 ^ OTHER
<br />RETURN RECtIPT REQUESTED
<br />
|