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<br />If yon have given a lease to others for all or part of tiro property, elate the names of the ]easing corn.
<br />panics, partaerahips or individuals:
<br />Name \Innnger P. O. Address
<br />Is property worked contiauouslyt__________
<br />If work has been stopped, state when________.
<br />Nnme, title and address of person in ebnrge r
<br />State the character of ore_________!~-c~~s~,
<br />0
<br />State the value of the ore________.._________.
<br />y-
<br />'--L=f~-------------------------
<br />----- ---------- -----%~1.~------
<br />if work for you_____________________.
<br />-----------------
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<br />i1fEN E111YLOYED
<br />No. Employed No. Employed
<br />____.linchine Drillme n, $______for____hourshift. _____Engineers, _ _ _ $______for____hourshift.
<br />-____.llncbine IIelpers , $______Cor____hourahift. _____Pumpmen, _ _ $______for____hourshift.
<br />_____liiners, _ _ _ $______for____ltoureltift. _____Firemen, _ $______for____lroureltift.
<br />_____Timbernten, _ _ $______for____iroursltift. _____i3lnclrsrnitlra, _ _ $______for____Itoursltift.
<br />_____Trnmmers. _ _ _ $______for____trourehift. _____Tenmsters, _ _ $______for____Irouraltift.
<br />_____Ore Sortcre, _ _ $__..___for____Iroursltift. __..__Foremen, _ _ _ $______for____Itorrrsltift.
<br />_____Topmen, _ _ _ $______for____Itourslritt. _____Superintendent, _ $______for____Irourslii[t.
<br />_____Laborera, _ _ _ $______for____hourshift. _____Oflice Help, _ - $______for____hourshitt.
<br />_____Assnyers, _ _ _ $_-____for____bourshift. _____i1lil]men, _ $______for____honrsbitt.
<br />_____]'slectricians, _ _ $______for____Itour-shift. _____~Vntchmen, _ _ $______for____hourshift.
<br />---------------- - - $------fcr____ttoureltift. ______________-- _ $__----for----hourslti[t.
<br />Average number of men employed this ycnr______ ___________
<br />Is there n rnill7______ __________________________ _
<br />Nnme of mill-------- -------- ------
<br />------------ _I,ocntion of mill-------- ----------
<br />-_
<br />Charnetcr of mill_____ __________________________ ______ ---------___
<br />~ Capacrty of mill---------------------------------`When was millcrceted____-----------------___-._
<br />Give list of buildings, tramways and other surfnce improvements ~
<br />---------------------
<br />-------- --------------
<br />Cost of surfnce improvements made in 191Q_ _ _
<br />State amount and clraructer of underground development:
<br />Total Development Amount Done in 1913
<br />Shafts ------------------------ ---ft. ~.
<br />-- ft.; cost per ft., $__________ ~
<br />Winzea -------------------- ~O--ft. ~'
<br />~ --- ____ft.; coat per ft., $_..~4 _"'__
<br />~7 --------
<br />Drifts -------------------~711]?I(---ft. - SJ,~ .
<br />-----~p-v9ft.; cost por ft., $_10_.=`:_ ~-
<br />Croeacuts ______________ __Q~,q___ft.
<br />---------___ft.; cost per ft., $_12."__
<br />Have you reported to this department all fatal and non-fatal accidents occurring to workmen in the
<br />~ .
<br />twelve months preceding the date oP this report, ae required by ]nwt _____~_(_~~~y~ _.~~cx~"
<br />Remarks:------------------------ ------------------------------------------
<br />------------------------------------
<br />_. _ ..
<br />- ---f Signed----------------------------------------Company.
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