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L~ y <br />`~ I'I'P/age z) <br />MINE ZD # OR PROSPECTING ID # mAtl-~ `fit" <br />INSPECTION DATE ~-1 _ q ~ _ INSPECTOR'S INITIALS_~ <br />OBSERVATIONS <br />~~ 9.~.,„~~.s.,,, ca1v~A,u.,c-~ ~ .inn-(~.~,t-~o~n ~b ~-~.t ~.~ (~ ~.Q.e ...~,.n -}-~L, sue. <br />`j~JLvi.i,.n-~' d:~nv~;~ -~-,,,~. ~,~,~t,~-~,,a,,,, a,,,,d~ ~,r,,~.~,,,,'! ~ r~l'~z;~c~n,,~ <br />I~a~d..~n~-~ ~ CL ~ ~L G- ~ 0 <br />o ~~ -tom. c,~~~ ~-~.~~ nR~a-c.~, ~ . w~~--+.~v.~ s-t.st~ <br />L~.Q.~--ate ~ -~„re. ~ 5~ ~ ~-~ P~ ~.1,-}e~.~.~Q _ <br />~~M ~©-c9..~ ~ 3, y- , ~`~'~ cJ~-c~r~ ~c~ Css-,,~v~kn,~ ~`~C.Lw~rP Sec-~+.~m <br />c~-~~ -' <br />I & E'~Co~ntpact Addres~sl <br />NAME . 1 V KM H NA [ Jt <br />OPERATOR l ~,~ ~ 4 (7 <br />STREET `~~ ~ ~ n1C l9 I <br />CITY/STATE/ZIP V I C ~y~.. ,~) ~~~_ <br />cc: ^ CE J~Q J'~-e.U(,v~ <br />^ BL <br />^ FS <br />^ HW <br />^ HMWNID (CH) <br />^ SB <br />^ WQCD (CH) <br />^ OTHER <br />