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<br />~ i <br />(PAGE Z) <br />~~MINE ID # OR PROSPECTING ID #: /~ - ~ '~ - 2. L O - _ _ <br />INSPECTION DATE (~ ~1Q2 ~l~ a-- INSPECTOR'S INITIALS ~ ~~ <br />OBSERVATIONS <br />sG/ oc~ ~/ <br />~~ <br />~~~ <br />I & E Contact Address <br />NAME CC: <br />OPERATOR <br />STREET3gaD D <br />CITY/STATE/ZIP ~~j-G~p~~ir..+~C~ W g~10~ <br /> <br />5149E <br />