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(Page 2) ZO~Z <br />1 ) <br />MINE ID # OR PROSPECTING ID #: f~ - ~~'~ GTJ3 //~~ <br />' INSPECTION DATE: ~ -j D6 INSPECTOR'S INITIALS:~~ <br />OBSERVATIONS <br />rCv-~^- ~~/~- `~`~C PeYz~l~ ~tf' GQ ../~f !~-of ~~ ~~" Fly <br />GoveJ <br />( ficei~/ i <br />f ~ ~ ~L ~ ~ ~ ~/ <br />~ <br />~ ~ 1 ~.- <br />~- <br />i.r~ <br />rc o~~ <br />Sr~~Q r ~o r <br />//~~ Q ~~~~f~e~7~~ <br />~Zl,e ~~ spa 5 z' A <br />v ~ ~/~r/-~GC Z~ Gc ~zs /~ - <br />Q~r'GG` ~sY+- l-elt~`9~Irf7il[<`i~ LS ~Grl1~d'• r~- <br />GYGc~~`-c--~ wtl~//~,~/w`~- l~~/-, l ~/ ltu.Q,r'f~/~`G Co _/P ,y~st1/ <br />l ~ Ge ~f / o R~~~~G ~(iC !~'1-lf Gf PGlfl~~-~/f~ 6f'r- e ~oll~ ~O / r /~c ~yf" <br />L~oQ ~~G`~.c~1c~ li'o~, by ~~ZT-Y ~a ~~~ ~ ~~pp~~v~,sl~ , <br />G~. aP/~~ <br />I & E Contact Address ~J ~ o ~ ~ ~ar~ w+ ~ S C~~J <br /> <br />NAME -~yynq`~ <br />^ CE <br />cr <br />: { !+-+~K(jJ/R~Dr . <br /> ^ BL <br />OPERATOR: ~~-.~1{ ~ O ~ ^ FS <br />^ HW <br />STREET: LFD( C{ ~Gc. / 'z° ^ 5 MWMD (CH) <br />CITY/STATE/ZIP:1,(/~ SeL~ ~~~ ~~, ~(0~9 ($OT~HER(CH) <br /> T ~-~- Stt~w; - Df'I~ <br />~1- ~ ~-3 b ~ 83 ~8~ <br />