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<br />• (Page 2) <br />MINE ID # OR PROSPECTING ID #: h'(- ~~ $S-f 73 <br />INSPECTION DATE: ~ U - l•l -DO <br />OBSERVATIONS <br /> <br />INSPECTOR'S INITIALS: <br />(moo f-tP~-T}Se.~ A-ti3 lnT~taeC.7T,enJ p~ Y'LO-t5 SGT R~5- Pa1•n7- cs6- /~- Kro3ep <br />(~}/,tb Re-~-t,A-~T+q-Ttaxs (3aA-R1~ ptRe,c.rcve ~b rassRee~- eUerzyy Krare /~u Tie, <br />5'~'yp A-~ ~~a1-ST oarGrz eve~a.y+ r'6~-+2 Y@A-2S. Y"!4e ape2p-'~rco~t ta}R-5 L~FSY' <br />f~SPaere~D 6,J JAnru~]--RY a3, l~kg7_ <br />Td+bs IS F} Ili RCS P-~rdSR-GJ Re.Gu1.-i+n !>~ PelLr-cr`T; <br />°T'abe ~ Px >e n-"~p c 6-.r-rz aru. ~s Ta r-r ~ ire 5s+o~sp ~ G 2~+ue-~ Ft,~F~R IA-e i a3 <br />(' {{-a-Se ( ~T fn c ~ (n t ~ C-~C.sl--vim D l ,~s Yz-,~ >~ So ~-e.PU-e~}S~' /~r}n'T` a ~ 77-~ <br />~'C,RD-L'LT R'~-Q~'r <br />T13~ P~R.K,r Brsunrc,q-2~ tS ~-A~~,uw~L4 Deu~re~a-ter, ~-rr~ ~~4eD <br />~ rr2e ~etisc2~ 4c~5'A L~cso~ s~A-r2es. <br />'~EfC'_ !-'f r tiS~. ~ b S t ~N D I S P C-A~4' S ~~ ~~ tl.TC~eSR 2eC,T j-~C~2aY r T <br />,stxc-irg.~~, T/~ ~n~csz- nruv-t13.~2 c5 rI-SS-f73 ~c~R !°i-(~8S- <br />!'Z3 T-rae htew x,'~urcgrz,2.taSC 5'>"sT~h ~. 7~'t~ c~rc~LL 3sz, pro a~e,ra ~5 <br />~ (' /16~} LP.M C~ ~ PA-G~- 3 0 ~ Tz~a ~ R e-P~R~ _ i 3~e. ~-rt 2e ~-r-c cr e <br />n-~-s G~,v.r a~u,e D~h'se t 5 se-y- ~~ De.~e.rc ~~a2 ~7~ ~o~ <br />-r--i~ p-~ 2.2r~oi2, t 5 1 /nT Con-'GF~I~e<#aJ~-2 us[`[Z-F YZ[e. <I'PP~C-fftJe,tiJ rr ra?rn16 <br />(~119Ds~ a"r"zF~Q Thy- -q-~i K ci.Te ~b SG~~ , <br />~~ to (2odiC~fFS <br />Ce~ - -~ ~ ~ 3 ~ ~ ~ ~ <br />I & E Contact Address <br />NAME: F'((IK//Q S f1L.r TTl2 R <br />OPERATOR: t~ l 6 t.1SlA Cer~c oJTV <br />STREET: ~,~. ~ (7~ (DO <br />CITY/STATE/ZIP: I~LkDS ~ , $ ~ G3 <br />3 `~~ <br />~A-o--re~ S•t-eve.,Ts <br />cr ^ CE <br />^ BL <br />^ FS <br />^ HW <br />^ HMWMD (CH) <br />^ SE <br />^ WQCD (CH) <br />^ OTHER <br />