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<br />' M(PJE ID # OR PROSPECTING ID #: - / `'( ~~ { ~a
<br />INSPECTION DATE: ~ -Q -O ( INSPECTOR'S INITIALS:~~
<br />OBSERVATIONS
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<br />~r35v'2u..e.~~aa3 a6L '['6i2 ~u.c-tl' ~o,uYZEr..vtce-.v"i''Ne~2 u:-l..e,a-e 7'~Fe
<br />IrtP~"s~~-c~`~-"'' P~r~e.Ltnre. [Zu~~u.ae.p c.~4sv- nsooe.o~ci3e-2. ~srnuen~
<br />oR gs665 diS~tl-eA Ctr~77'tt~>~eeoJT ~~u•~' ~~ '~" G°RRe.c~~cJe ,4-~.l'zaN
<br />[ u 3r~b~ GJ e-~° ~rc,+~~ t 3', at7oo [ i.S S P¢ e~4'ecT~u Re1~24' . r w-e_ o Ems.!°.l~Ya R
<br />u?t DQ-C.7ea YZd-e ~u•LC-`G I~e.zXst¢, GRN-[LLD b'~e ^~o/LT6F ~ dou'r~c bi4-nJKS '
<br />7b R a; t eR Le33 ~' SC.aFe r~n3'a iWSTY~ueA A- S~-4 Q /T.o/o `sF7Z,Clc~T7-eR2
<br />pr.Z Y7~e I}c,C~SS P°`4'!J ~°~-'-c,~rPl2Y'. A~ A5-C3utc~- RX-Ra2'~' ~zc,e.. f3~
<br />5 ~ /io-[- [ rib ~ ~, D evc s c aw c ~ c ra~c aS 3~ A~4`+'S 5 be aw tea6 rxFe.
<br />l' bo-2e.n3~,ccsat S o&~ `~~ ~ ~-t-o-t~° ~F/~ R~ n T[te, tJ2vB .>T2r.e ~z.[.~e~ k 5
<br />~-e.T ¢.t_C.. ~~ 9'[.62 Uf~t~S •a~G¢J~1a`c6~~ $o ~- ~racu,r"ce~2te
<br />C!4" L~ cx L.+~ o c.1 ~yF~ /S-Q ~e-a-c. F~ t,2~'e-b . i ~ rwz e. c'-~ (~ t~'`Z ~ S e (n,ecs 1c
<br />-(-'Cq.e, ~F~R•eUa~2, 2~vP~5° Ttuo i~-vuR,S CcN'~rc.-e ur1A~'P-~l G5 T~ Cl1H/~
<br />~l2,os-c 3Z4e tst3~e.5 T F~l T YU TSF~ lam-![-/ trS~ /t"tN Gl.~~~7 a z Z a[.G~ i
<br />trR . a t ~4-~-~7'. 1~ `t-aze. ~RX4Z'-ce.~C't' 1 s 2e.D uc2.fl ~ b ~+~~2~ 6"fo-uR,
<br />-f-k{ ~ Se.Lr•L~ fyu-Sr ee. e.q Pi4/3Lc'- ~ ceasT~tcatasG ~p,3, 3'77 GA•11o~aS, b2
<br />13 .0•C - tr='r , 6 rt le.~ [-cu 5-~ Aso-tn,t v Yb Rrcrca Lr t a1 ~ A~~;-y !~ H'e c. e ac e
<br />Lp~.~/¢C~e ~t2tspi 'ry,Ee. S u!'Q.lo f~oJA 'r'RRN~PaR~' t r Yo 7"/~- ~i'Y~%4/c.lat6S
<br />Pa~p_
<br />~-~ R`i, u.o.Tt4- l,~-A's R-eeos P~-~,2`-c/~6 ~r .a k(-t~~-F ~~ee.t~-o~r~y
<br />[2.r4~'e- S ! DJC e. ~'6Fe. L W- S Y' 'S l to eft cx~~ $ R•!~ ~ uA-~.SC,e. ~~ Sfv.J'~-gam
<br />b~'S boa Pu.rtReD ~
<br />p,2,E`~~c /b~Z,,
<br />5-~ '~ 6-LL ~ 3 f 6ti p v 5 S lri [ic' 1xT2-a s'~e-aJ ~ ixr ~.~.5 G Y ~~ S, ~7~1-~.
<br />o ~Z~ 0°[/•--ors YO Cs.o~.l~LnSU,e P 2[ZL 6R-`!'L nTC= Te-Fe C) ~Ge'r'1+Y¢!J
<br />dq'Y~,2~ a ~ •SL1e (~.pcszc `.51J rceso~ /i~J D ~ A-LS-o~ (l L.~Fo.sS Tb R2r! a7~Y/~L
<br />,~~,- ,~.~µ [ Herz 50 ~~~e3-~~L-~ P2oe_c~ss~s cA-+J, a~.s~
<br />L16~'f^~, 2'e Rc"'"~ ~~. 5 [ i~ a~ T6/~ Pd/.SA,
<br />~-lsje., ~ f th S G rra5 r-{A-S a'~•CC D.ep °t'ro ~t~L~,Ccz. e1 mss c T~ ~6 t A15 P~dTlO~
<br />(1,4R..P~[u,~A.JL'!`t' TO o~~ .e.CS~IL`1 o-~cQ~-l~ Naeu`bzF C,b~cr`:St~iLY, ~a rr,~e
<br />~~-t•e,~ j troJ~e.Q. Pee ~Q~-'H-r~a~ J ~a.~.Y•~~-cs A-Na~aea2 ~4.ic12 PRd3c.eK
<br />b cc'~u, r., S-, I~ u,YbKr}~c C.1-t.Ly'
<br />la•L.'at>, T4fe ~ttTl~i.or~ u.icGC.. ~'24'S2~S4~4~GsSg C°..D~Ce:> ~F //•TSF~Q~TLDZ!
<br />~~j1,g3 4a H R , rZA•~%t.o UY,~ dZ F}2T b N E: z'i ~ t o.~ TCbe ECG fu. R.C, F-GR,
<br />I&EContactAddress h1Y~-lLTtoY~°~.`J2~J~5>~/~" wRLTGe•3&~/~ ~.'eP`l~ JAneS S~~e.t3'RA1S
<br />/ shovcA
<br />NAME: ~/Q-(I~ l~~il~(o cc ^ CE
<br />~/ ^ BL
<br />OPERATOR: ~q-f[~. /c'IOI.e/JTI~-L/J /Ce~~-lRfi'1z-S /!~@• C7 FS
<br />HW
<br />~7 /~ HMWMD (CH)
<br />STREET: !"~ ~, /~,~3L' ~3~~ C~I1Q'CCvt1[c
<br />CITY/STATE2IP: ~~J3 ~1.1,( 5_ `pT, 8 1 l5a ~~~e~ ° ~^'Q ER (CH)
<br />Pao. tJO~C <6~-
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