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<br />(PAGE 2) <br />' MINE ID # OR PROSPECTING ID #: ~ - ~ O - 1 ~~ - _ <br />INSPECTION DATE ~ ~ /_~ ~/_ (Z INSPECTOR'S INITIALS N ~I P <br />OBSERVATIONS <br />'I C~.e ~ ,~;i .tom L~~a t~ ~n .:.,~. 0. b ~c c a ~.. yw+•-, ~ m ~ ,,,,, zo~n•e s.,.,.~C.~ <br />y~ ear ~-~'I,.e ~n, y1 ul /~ 4 rVU USj a , r 1J e/t. 1.~.~a.1 ~-~.9 ~n Wca,CXi.- CTU~c.~v <br />ov. ~ e e. cvr f I ~-a(0 'YY`u'~ ~ d.v. tl ~t l~'~~~ Stcee ~~ d s <br />li.u~a.-„-~. (fie oa...~,,, e .~ T a I~.~r,.~.~ 8 .~.~-~ , <br />~ ~ ~p~ ~j- ~ <br />I <br />.~,.e..~ a,..~..~. . <br />'fie 0 ,w~o~..~ ~.s a~ ~ r~~Q a T (L ~o adp~ ~ a.ct~.~_ <br />.4-an-~ cl~ ~. ~--e~w~ ~~qs ~ ~F*k c.I .~v'1- <br />~1.-..-4 c~.e I,~ rw.~ .Gem J r-c-~~ . / <br />I & E Contact Address <br />NAME .~dc~ Gr+~~~Lu-~ <br />OPERATOR C ~ J G ra ~/e~ <br />STREET ~ l4 ~'ouyl4y IZoa~ Soq <br />CITY/STATE/ZIP ~~N~CIo CO 8l(37 <br />CC: Dz~ Herh~~d~z , NL~~ <br />5149f <br />