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<br />MINE ID # OR PROSPECTING ID #: (n -Q~~~~,1{.l~
<br />INSPECTION DATE: I e11 ~ ~ l ~1,~I INSPECTOR'S INITIALS:_~_
<br />OBSERVATIONS
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<br />I & E Contact Address
<br />OPERA
<br />STREET:
<br />CITY/STATE21 P:
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<br />^ BL
<br />^ FS
<br />^ HW
<br />^ HMWMD (CH)
<br />^ SE
<br />^ WQCD (CH)
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