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i? ~i `` rr~ ~!: . ! tI I` ~}~~ t; .1 I .~'. I~ I'i 1'i ~I I j ~' i ~~~ 7 ' 1 I 1 i ~ 1 / :' (~~ 1 ~II'I. `r~ II i -f l) ' ' ~j I~ ~II f ~% ;. ~~ i i (.: a~` f If yon have given a ]ease to others for aII or part of U:e property, state the names of the ]easing com~ Parries, Partnerships or individuals: 1\ame 11lanager P. O. Address ---- - -- - -------------- --- 7a property svorL-ed coatinuoualy;_ _~ __ ------------------- ____ _ If work has keen sto ,t ---- ------------ peed, state when--__?C ~' ----,:. T! • ----~` ~ --- i / s Name, title and address of person in charge of wort for ou______;_ _~ - - 0792 ~ ^-------- ----- -------------------- n State the character of ore-_-` ',-,~--~-~-~----------------------------- ------- - -------------------- .o ------------- S r-wrc.a~i fate the value of the orb _________ ~_ ---------- ---------------- ----- -------""- ---- ------9 --------------- %EN E-1PLOTED No. Employed I~'o. Employed ____linchine Drillmen, $______for____hourshift. ---__Engineere,_ _ _ $ f h -___'tlachine He]pers, 4______for____hourshift. Pumpmen ----- ______ or____ ourshitt. , _ -_ llfincrs, _ _ $~```__for_~ honrsl:ift _ $______for____hourshift. == _ . _____ Firemen, _ _ --- Timbermen, _ _ $______for___ hourshift _ $______for____hourshift. _ • _____I3lacksmithe, - _____Trnmmers ¢ f - ~------for____hourshift. . _ _ _ ______ or____hourshift. ____ Teamsters, _ _ _____Ore Sorters - g------for__-_hourshift. . _ fi_____ _for____hourAhift. _____Foremen, _ _ ----_Topmen c - ~------for____hourshift. , _ .. _ _ _____for____hourshifl. ___~_Superintendent, ____ Luborers _ 8+~ _V-_for_ ~_l:ourshitt _ , _ _ _ $______for____hourshift. ___ --OIIice Yelp, _ --._Assa}-ers $ f . - g--_---for_---hourshift. , _ _ -.---- or-_--hourshift. ---_- ilI}Ilmen, _ _ _____P•.Iectricians, _ 4 f _ $______for____bourshift. _ ______ or____hour-shift. __ -_Rutcbmen, _ _ ~______for__ hourshift ---------------- - ~- ----for----Lour shift' ---------------- - __ . _ 4______for____}toursliift Z Average number of men emplo}-ed this year__ `~! . ____________ _ Is them amill°---~7<~ ----------- ----------- ------- ----------- - ---------- ------------- Name of tni11 -- -------- ------------- ---------------------------------l.ocaiu^ nt mill---_--- Chnrncter of mill-------------------------------------------- ---------_-- ------ - fiIIpllC]tC Of mlll_____________ _________________.._~`~11Cn R'aA m111 CTCCLCd _ ___________________ .__ __- I--------------~~-- Give list of buildings, tramways and other surface improvements ~_! ~.- (.~ A r/i. / , , r i l!: ,/ / i~ ~do-L / ` ------ ----------------- ------------- ------------ ------/----- Coat of surface im xovementa wade--ia-ly3___ ____ _ --- -` --'---""- State amount and character of underground development: $ 'Dotal Development Amount Dona }n 1913 Shafts --~---fit - ----------~/O_ft. ! - it P H f _ ft.; coat per ft., $__________ ~1'inzca ----_--- ___ft. ,( u~~~---~--- __ft.;co~tperft.,~_.. Drifts -~___C-' --- 1 ~O_ft. ---------~ ---_-- - ..., ~ ft.; coat ter ft., >J;_(_S _ ~ ~ ~ ~ CrosacutaL`~Z~c~~[ ~C~ __ ~_ft. ----- i/' - I C "`' ;J__ft.; coat Per ft., $_:f___ }fave you reported to tide department all fatal and non•futnl accidents occurring to workmen in the tweh•e months recedigg the date of thi report, as regtu~e by Inw1 __ G~~`_ ~~-~L,; Eewai'ks:_~~ai;t,~-~'~ i3~s~ (~ap~ G~~' ~--- - s,(_~-r.~~l-- ---- - --- G:~.,. A, ~U ~ - ~ - /~ Il ~„-u;.-.~ . ~1ZO~ ~e_l{~ _-~.~~ .-~-,,..0.11: P`. -- +-cap-ti' /`^' ------ Signed~G[eF/rt ~iinv</i~i~<,~.<;_ /- , G-~~a/ ~ /` /i Title------~---------------- ------- 1--- .;