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<br />MINE ID k OR PROSPECTING ID #: ~ 77S "fig' F*
<br />INSPECTION DATE: ~~-~-/o ~~~ INSPECTOR'S INITIALS:.1A
<br />OBSERVATIONS
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<br />I & E Contact Address ,J + h $T'eU2.~) $
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<br />NAME: F'1 I C 1-}~¢e.L /..Q- p FCl-( ~~,~ ~~~ cc: ^ CE
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<br />OPERATOR: Ro-Q tw75 tr,~7 /2 2 f CIL e-O . 1313 s~~hH'"i ^ FS
<br />STREET: / $~ ~ !~ C(), ~,¢/L'r/-r 6frt7"bF , ~+t771 ~-~J~ ~~~ RO aO 3 ^ HMWMD (CH)
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