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<br />If yon have given a lease to others for all or part of the property, state the names of the leasing com•
<br />paniea, partnerships or individuals:
<br />Name Itfanagcr P. O. Address
<br />--
<br />Is property worked continuous]y1________________________________________________
<br />---------------
<br />If work has been stopped, state when_________
<br />----------------------------------------------------
<br />Nnmc, title and address of person in charge of worL• for you_________________
<br />State the character of ore -------------------------------- ------ --- -------------------------
<br />-----------
<br />State the value of the ore________________
<br />11fEN E11f1'LOYED
<br />1Qo. Employ ed INTO. Employed
<br />____Afachine Drillme n, $______for___hourshift. _____F.ngincers, _ _ _ $______for____hourshift.
<br />____1linchine IIelpers , $______for____hourshift. _____Iumpmen. _ _ $______for____hoursbift.
<br />_____Dfinere, _ _ _ $______for____hourshitt. _____Firemen, _ _ $_______°or____hoursl~ift.
<br />_____Timbermen, _ _ $______for____hourshift. _____I3lacksmithe, _ _ $______for____hoursliift.
<br />_____Trammers, _ _ _ $______for____hourshift. _____Tenmstcrs, _ _ $______for____hourshift.
<br />_____Ore Sorters, _ _ $______for____hourshift. _____Foremen, _ _ _ $______for____hours}lift.
<br />_____Topmen, _ _ _ g______for____hoursl~ift. _____Superintendent, _ $______for____I~oursliift.
<br />_____Laborere, _ _ _ $______for____hourshitt. _____Office help, _ _ $______Cor____hoursbi[t.
<br />_____Aseayers, _ _ _ $______for____hoursbift. _____Dfillmen, _ $______for____hourshiCt.
<br />_____Rlectricinns, _ _ $______for____hour-shift. _____\Vatehmen, _ $______for____hoursbift.
<br />---------------- - - $------far----hour shift. ---------__--_-- _ $___---for--_-hour shift.
<br />Average number of men employed this ycnr
<br /> ________ __________________ _ _
<br />
<br />Is there a mill4______
<br />____________________________
<br />_
<br />-- --------------------
<br />
<br />A'sme of mill-------- ------------------
<br />---------------------------Location of mill-------- -------------------------
<br />-----
<br />
<br />Character of mill-----
<br />----------------------------
<br />-------------------- ------------------ -
<br />
<br />-----------------
<br />Capacity of mill_____ ___________________________«'hen ~vns millerected_______
<br />Oive list of buildings, tramways and other surface improvements ______________
<br />,,l ', Coat of surface improvements mode in 191___ _ $ --
<br />State amount and character of underground development:
<br />i
<br />~ Tots] Development Amount Doae in 1913
<br />I' ~ Shafts -----------------------------ft.
<br />:, ------------ft.; coat per ft., $----------
<br />' ~I Winzes ----------------------------ft. ------------ft.;cost per ft., $_..--------
<br />!'•'`' Drifts -----------------------------ft.
<br />i~ " ------------ft.; coat per ft., ffi----------
<br />' Crosscuts ----------- --------------ft. ------------ft.;coet per ft., $----------
<br />n ~kI $ave you reported to this department all fatal and nondatal accidents occurring to workmen in the
<br />~,
<br />twelve months preceding the date of this report, as required by laws ________________________________
<br />Remarks:------------------------------------------
<br />{ .
<br />~I`II ------------------------------------------°------------_-------------------------------------
<br />,,i I i ~'
<br />i!~~. ----------------------------------------------------------------------------------------------
<br />Signed------------------------ -----------Company.
<br />IIy------------------
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<br />TiUe_______
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