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<br />~~ , ~ It you have given a lease to others for all or part of the property, state the names of the lensiag com-
<br />paaies, partnerships or individuals:
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<br />te7 \Innn er
<br />~ { 6 P. O. Address
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<br />Is property worked continuous]y4_______ __ __~_____________________________________
<br />If work has keen stopped,stntc• when______________________________________ _____-_-__-
<br />-----------------------
<br />J Nnme, title and address of person in charge of work for you_____________________________ _
<br />t 'i -----------------------'--------------------
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<br />i State the character of orc________________________ !~~_ __
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<br />- State the value of the ore_______ ~ - / J J d a~-
<br />•~ ~~---_^~~----- ~---~------y-------------------- -----
<br />11IEN E:1IYLOYED
<br />No. Employed No. Employed
<br />\fachinc Drillmen, $___..__for__.._hourshift. _____Enginccrs, _ _ _ $______for____hourshift.
<br />___. 1[nchine Ifclpers, $______for___hourshift. _____Pumpmen, ¢______for____hourshift
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<br />_____;\Iiners, _ _ _ $______for____hoursliift.
<br />_____Piremen,
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<br />_____for____liourshift.
<br />- $-
<br />., _____Timbenaen, _ _ $______for____hourshift. _____i3laclamiths,
<br />_
<br />_ $______for____lioursliift.
<br />'I•rammere, _ _ _ $______for____hourahift. _____Tenmatcrs, _ _ $______for__..._hourshift.
<br />_____Orc Sorters, .. _ $______for____hourshift. _____Foremen,
<br />_____Topmen, _ _ _ $______for____hourshift. _____Superintendent, _ $______for____hourshi[t.
<br />_____Lnborcra, _ _ _ $______for____hourshitt. _____Ollice IIeI
<br />P. -
<br />- ~;______for____hourshift.
<br />_____:lssnycra, _ _ _ $_____..Por____hourahift. ___i,fillmen, _ _
<br />_____Electrieinns, _ _ $______tor____bour-shift. ____\~'ntebmen
<br />, _
<br />_ $______Cor____I~oursl~itt.
<br />---------------- - - $------for----hour shift.
<br />------- _
<br />---------
<br />_ $______for____hoursliift.
<br />Average number of men employed this yenr ,~y
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<br />_________
<br />Is there a millt____~!j /
<br />---------------- __
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<br />-----
<br />------------- -----------
<br />nme of milt-----------------------------------l.oc;dion of mill----
<br />---------------
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<br />harneter of mi]1---------------------------------- ----
<br />
<br />-----------------
<br />______
<br />-------------------
<br />Capacity of mill_ -----_---_-- --
<br />_ _______________ _ _________ _.~
<br />- hen was millereete _______
<br />---- --- -----
<br />rve list of buildings, t
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<br />am
<br />ways and
<br />other surface irti vementa r
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<br />---------------------
<br />-------------
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<br />Coat of surface improvements mode in 19]
<br />
<br />--------
<br />----------
<br />
<br />
<br />-----------------------
<br />___ _
<br />State amount and character of u
<br />d
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<br />erground developm ent:
<br />Total Development Amount Done in 1'J13
<br />Shnfta -----------------------------ft.
<br />-------_____ft.; cost per ft., $__________
<br />Vinzes ----------------------------ft.
<br />-----_______ft.; cost per ft., $_..________
<br />----------ft.
<br />Drifts ------------------- ------------ft.; cost per ft., $----------
<br />Crosscuts --------------------------Ct.
<br />------------ft.; coat per ft., $- ----
<br />$ave you reported to this department all fatal and nonfatal accidents occurring to work the
<br />twelve months prec diag the dote of this report, ne re uired b Inwt _____________ •
<br />Itomnrks:----7' ~`' ~'c~t.C.. __~~ - q^,~ y ------------ ~ --
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<br />- _r.41.e2._ _ '
<br />___________ ________
<br />_ ___ __________
<br />Signed------------- -------------Company.
<br />--7-//-'~~-------
<br />Title-----------------
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