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If yon have given n lease to others for all or part of the property, state the names of the leasing comma' <br />ponies, partnerships or individuals: <br />--- -Name ~ b s ~ P. O. Addr <br />----------------------------- ------------------------------ ------------------------------ <br />Is property worked continuoualyP___ '_ "______~p_ ~7- ___________________________________ <br />If work hna been eto ~ ~,r w ( `t __ <br />pped,etnte wheu_~_L_ _L ~.________ _ ___ __ <br />Name, title and address of person in charge of work for pou__~' ~~_~__-_~f~l -L---------------- <br />-------- y-~= =--------- <br />-------------------- -------------------------------------------------------- <br />Stntc the charneter of ore__________~i _ ~~ ~___ ______________________________________ <br />-- <br />----- <br />State the value of the ore____________________ <br />11IEN E111YLOYED <br />No. Employed No. Employed <br />~___llfnchine Drillmen, $______for____hourshift. _____Engineers, _ _ _ $______for____honrshift. <br />____Hlncl~iae Helpers, $______for____hourshift. _____Pnmpmen, _ $______for____hourshift <br /> <br />_1~ Itfinera, _ _ _ <br />$3. y_°_for_,~_hour shift. <br />_____Firemen, _ _ . <br /> <br />_ $_______ar____honrahift. <br />_____TimUermen, _ _ $______for____hourshift. _____Iilnekemitha, _ $______for____hourahift <br /> <br />__~__Trnmmera, _ _ _ <br />$.3 yc__for_fl__hourshift. <br />_____Tenmatcre, _ . <br />_ $______for____hourahift. <br />_____Ore Sorters, _ _ $______for____hourehift. _____Foremen, _ $______for____hourehift. <br />Topmen, _ _ _ $______for____hourehift. __1__Superintondeat, $,~__°~_for_~hourahift. <br />_____Lnborera, _ _ _ $______for____liourehift. _____Cffice Help, _ $______for____hourahift. <br />_____~ssnyera, _ _ _ $______for____hoursl~ift. _____hlillmen, _ $______for____haurahift. <br />_____Electricinns, _ _ $______for____hour-shift. .____R'ntchmen, _ $______for____haurahift. <br />---------------- - - $------for----hourehift. -- <br />-_------_--_-- _ $___---for----hoarehift. <br />Average number of men ,Q <br />' <br />employed this ycar___ ~!`!_________________ <br />J -- <br />------------------------ <br />Is there a miIIP__ ~1L <br />- <br />------------------------ <br />- <br />-- <br /> <br /> <br />nme of mill---------- <br /> <br />------------------------ --------------------- <br /> <br />-Location of mi]1-------- ------------- <br />----------- <br />-------- <br /> <br />Charneter of mill------- <br />------------------------ <br />------------------------ ----------------- <br />-------------------- <br />----------------------------------- <br />--------------------- <br />Capncity of mill_________________________________~vhen was mill erected___ <br />------------------------ <br />______ <br /> <br />(live list of Uuildinga, trnm~vays and other surface <br />improvements __________ <br />---------------------- __________________ <br />____ _ <br />--------------------------------- <br />------- --- <br />- ----------------------------------------------- <br />Coat of surface improvements made in 191 _ _ <br />State amount and chnrnetcr of underground development: <br />Total Development Amonnt Done in 191# <br />Shafts -----------------------------ft. __~Y_~I __ft.; coat per ft., $_/O _°~' <br />---- <br />inzca ----------------------------ft. ------------ft.;coat per h.,$_..-------- <br />Drifta -----------------------------ft. <br />ft.; coat per ft., $__________ <br />------------ <br />Croeacute ------------------ ___ft. <br />----- ------------ft.;coat perft.,$---------- <br />$ave you roported to this department all fatal and aan-fatal acciden ocenrrtng to workmen in the <br />twelvo moatha preceding the date oP this report, ae regnired by laws ~_______ <br />Remark~:___-- __-- Y1~Q -~ LSiLLL^ <br />/ ~ ------- <br />Signed_l _ - -- -" L[~ <br />~"'- ------ -9 <br />----------------------- <br />Title--_Q/_'_c_~_t_L-- ~~------- <br />