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(Page 2) <br /> MINE ID # OR PROSPECTING ID #: 0 a <br /> INSPECTION'DATE: INSPECTOR'SINITIALS1 <br /> ' OBSERVATIONS <br /> an.LA.n, <br /> e-V <br /> 4, <br /> �y �° ° � �, l"�.�- d+-.�.�.�a ,�..a+H Y'�-� a"".."L�Pr.-' a'.�'`e'• cv,r-a ( � . D r� tLCu�J, <br /> i3 A <br /> c <br /> v �.f w. a ,w� ✓ (( (l. . <br /> A.4 <br /> 11^-.d -.^.,.4Da^'�. Qco� �, ( 4-lA .e..j 4-*do- ro "1 �,i� • -�.,t J <br /> Cam•,,¢. r+'i,.,.,,,,/-- ��m c, <br /> I & E Contact Address o N.ILP N a r f <br /> NAME:° .Q�(Cmee�/P,� 11'kLNJIM+-�.y.nyAjL ❑ CE <br /> P,D• 1363 ❑ BL <br /> OPERATOR: 4L) ekXLn,w El FS <br /> ❑ HW <br /> STREET: I'f W D0 , 1/; S d 3D (o El HMWMD (CH) <br /> �! au -. ,/ ❑ SE <br /> CITY/STATE/ZIP: D sr�u t7 1 (-O . �O Z - 7 S ❑ OTHER (CH) <br /> / <br />