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• (Page ~ ~ 3 • <br />'MINE.' SD # OR PROSPECTING ID # IM1''1/^ E'O ^a ~~ <br />INSPECTION DATE ~~/~ 7' INSPECTOR'S INITIALS !%L <br />OBSERVATIONS <br />~'(rP! $i Zfi /~~'^-"~ a NO ,~1-d ~CR~yy~ (~VC/1R~ /ZOTQ~ a ,fJYdwh CD7~[~f <br />~~ Crn-S~ruc~z.H-, Ufi,,c. S' /W ~2a,Gz- ~C~c-c~i~ /~...e. ~~ <br />G~„a_ o-~6-ae/u~e.~ e No ~2n~rs Dv~a~z ~a2`o! <br />~_ /an~L .fa~s'scL Sfdc%~4- Se~- a+In..K ,Ca..f'~ ~ Tt,e n.e,,J <br />wr~l.e e,ra~..w~Q. ~irL. ~LP•ar ~ce~.ed ~~zd-C~. c <br />~b 6o,~F~'/ w~a ire ~c~ ~~ / ~v r..~. ~rer~~.~y <br />Q~ Div/Sa.~'v~ BKa~w~~ ~ e_ ~~'rnm~~ ~-~- /rr~c•~~•.r~'/ l~Lj~E <br />/in.ei' Ova ,~1~.~. ~`~~5-F //~.4Q<r~QR- .{%y~~~~~ ~ D/JIu~L G~,~/yi ^'/a""X a~.~n~v~g~' <br />c~ ~in4/' ~- ~ L!~G~x-/l ~ SC~rI/Yli/K.~ .4C.~^!/LiK 4~/f ~/ ~ 1` /'O~~/c{L,f/~~ <br />~o /pirnrv~¢-. > s~~ ,~ ((//~yts~c~.c.,,~ X02 ~.~p a.et~.~/, /plc.-c~e~ ~,~.o..i~ w.,.~ <br />/hctS~/zvt4. G~trw~ o`es~s u^ ~~¢ tea.- Gtr ~~ aryl itn~.a- <br />Qj~ ~~//s~.i-i /2K Oa.wt~'~L~ ~yYQ.~Ac.,,~. o,~~ia.vn Cvv'cr ~ .,~, <br />f ~~ "Cd2~ /Y+~.~i~~'S /~,q.G^'~^ Gin" ~0-8~ rcc~~iY~Gw-(~ <br />I 6 E Contact Address cc: ^ CE <br />^ BL <br />NAME ^ FS <br />^ HW <br />OPERATOR ^ HMWMD (CH) <br />^ SE <br />STREET ^ WQCD (CH) <br />^ OTHER <br />CITY/STATE/ZIP <br />