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• (Page 2) • <br />,.MINE ID # OR PROSPECTING ID #: /7 - ~Q ~0 Z 3 3 <br />r- <br />INSPECTION DATE: ~- Z ~ ~ 0~ INSPECTOR'S INITIALS:__~Qd <br />OBSERVATIONS <br />~i r(a c I j,.,.6f Q /rte.-/ Kl ~o/'!~J ~ l~+-!~ )9e<i('~'^' ~~ G~ L!/{t- G/ Q/~ I (~^LC' t/! <br />i ~„e ~l/'~i~ !Ls"~ l"~ILC~t/NI S ~~12-Gte/ ~Q[GC'1L!/ ~ ~Q/7'y~Oy''ntZ <br />7Lt.e p-crw-~t area is !H. ~~e .~~~~" sf~3 0 ~ t-~~la.~~-- <br />~-~ eaftP~~ ~~~6~ Z) o~ ~'Lt.~e ~er-H,-~p~~ area. ~t.a~~~pt~-~~- <br />~~~~j 7oj~follC~acN-~s'~/e~~• /"Le/~e/~'!ic-1wm~- e9' IQ(elfi~clsr <br />~~ Jlef ftavC el~i~lrlKP~ Io at ~.ril' -~oo~ <br />~ ~ ~~ <br />f f~-~~ <br />`~~ wL f~ ~~ k-Ci 1 .rf sa 6~~- ~~"'~c. ' Jl~~s~l t4a' ~`~ <br />~ ~ e~/~ <br />to ~.c-s^~ ~,~+!`~r~A G~ cc~ Jo <br />oef ~- ~C/1p ~~ // !' <br />~J l^C~ /xOI S / ~ eov~i ~~ S n <br /> <br />I & E Contact Address <br />NAME: ~(j(Q cc ^ CE <br />^ BL <br />OPERATOR: ' ^ FS <br />^ HW <br />STREET: ^ HMWMD (CH) <br />^ SE <br />CITY/STATE2IP: S~ ~ ~~if ~~ ~' 11 SZ~ ^ OTHER (CH) <br />