|
• (Page 2)
<br />MINE ID # OR PROSPEC^^1TING ID # /N ~9- a 3'/
<br />INSPECTION DATH ~nc-U7- 9~
<br />•
<br />INSPECTOR'S INITIALSG 7.
<br />~~~~ ~~ N d rw~..~:..~ w-b ~-'--rte do.,~ .~.~ ~~-m.e ~ .~.1~ ~,,,,,~,~,~,~, G-~
<br />1~...e G_...,, d.~.... ~.,~.,..,"t-Ly,'~.~tc ~ ,.yrn f[.Q ,o;,t.., ~ 4 ~,;F ~ o Lo~.~/e-~ ~~~
<br />b~'''~~~" ~Ly~~ a 3 u °76 ~J-a, ~,,,~„~.~ / -~ rh,u-oaf ,.~ .~ l..~ n,...~ea.../ ,
<br />a loon J'-ti.t.~~.l,C o~...~ J ~,_„ Ct`X°°'`ru'''°-h~'Q ~ s~j ~'(°~.L ~,._,~.
<br />~c0' '~.` c.wu`^~~ - •°~w`~^ w t S 'C~o- ~S ~t~.~u+.- .c to ,.~,,,.~,4e,;. J
<br />to tl.~. ~.~,,,,,~,_,J m.-.:1. ~ <.-..~ ~ Ta 9n-~-~,u-~-+- 1 1..,_ ,~.~L.,,..~..a/nx-1~-+..~.~a+-+ c.~ro~
<br />d.c-w,.,,,,,~. -r~ (~ o.~-~.~~, s ~4~1 ~Q ~ ~ , v,"c < <r',. ~ dam„...,.?' co..,„~~
<br />.~ ~ ~ ~{d''A" ,u..~-~,~ C~e.,.r'T a.......o r - ~ C~-~ c, 3 0 °~'o o " U"' ~, ,r-li
<br />~ ~ece ,~ -l~+ ~,(.,~.e c.~..~ . 3) C.trx,+~u.~f to -~ ~ a,r.,.~-Q•'-L~-
<br />e.. al~~~ S e r ~ .~, .~ `Le ~- a G ~ cou~e-~- °~ w~.-~+.J,Co-+naZ~,e~;
<br />~q~n~r-c~ aut~4, ,~ t,(a ~mny~.~p~rw~~Ce1+ i~~ rt,e.w0 g~~ ~ruir~
<br />// f}+ ~ 4 p,,,~,,,,,a' Z,.-:,,.c ~ ~ n ~ r ~ t ~ ~, ~ y~4.z 4 ~.,~~.-k..~-o-~-i
<br />~^*~ e~ ~ ~ ~ r d'd'ti d~ I a-.... <-kcnS~si,ba, ~ 3'75-a.p 44 ~ f~ 4 ~
<br />~p (~rl n.,Gt
<br />~~~- ~Mc-
<br />I & E Contact Address cc: ^ CE
<br />IIll // //~~ ^ BL
<br />NAME 4/0 urn ~o~xL~+-~S~ ^ FS
<br />~~yy /~ ^ HW
<br />OPERATOR It p D C..~-'v ^ HMWMD (CH)
<br />STREET ~~ ~ • _V,Q'1~ ~.~~~y3~~ ~ c~ ^ WQCD (CH)
<br />CITY/STATE/ZIP ~~~ ~~[J, $D ~ D~ ^ OTHER
<br />~e ~~`'~' e~ ~ ~ 296 608 256
<br />f~,{, i4v~ f~JW'Pi nF Pnr IO -rp~-f
<br />
|