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'I I i If yon have given a lease to others for all or part of the property, elate the names of the len„iag cum-
<br />i parries, partnerships or individuals:
<br />Name Dfanager P. O. Address
<br />' I
<br />i ,
<br />~I
<br />i ------------------------------ --------------•--------------- --------------------------....--
<br />~~ Is property worked continuouslyt_~ Y_
<br />--------------------------------------
<br />-----------------
<br />'~ If work hnsbeen atopped,atnte when_____________________________________________________________
<br />~ Nnmc, title nad address of person in charge of work for you~~a= -~L%;cx-=
<br />--------------------------------------
<br />State the character of ore_ ~L_>_`_*?:~___ ~ ~
<br />I -----~- ==-------------------------------------------
<br />----
<br />'~ !{'! State the value of the ore_L~ ~---------------------------------------------------------------
<br />1 ' DLEN EDIYLOYED
<br />~ ~ i No. Employed _ No. Employed
<br />_~_Dinchine Drillmea, $_!~ _for_~_haurehift. __v_Engincers, _ _ _ $______for____honrshift.
<br />'~
<br />" ~ ~P__Diachine Hel ere
<br />P $--____for____hourshift. _~__]?umpmen, _ _ $______for____hourehift.
<br />~ ~ _I]__Dtinera, _ _
<br />_ $______for____houraliift. _a__Firemen, _ _ a
<br />_ $_______or____hourahift.
<br />i __1__Timbermen, _ _ $______for____hourshift. _t___131nekamitha,
<br />_ _ $~___for8__hourshift.
<br />~_Trnmmera, _ _ _ $_ 3___for_~ _hour shift. _ ~__Teamsters, _ _ _ $______for____honrshifl.
<br />I _p Oro Sorters, _ _ $______for____hourshift. _J___Foremen, _ _ ~°°
<br />_ _ $,~ ____for____honrehift.
<br />j ! ! ; _3___Topmen, _ _ _ $,3_'_~__for____hourshift. _c2__Superintendcat, _ $______for____hoar~hift.
<br />_o__Lnborere, _ _ _ $______far____hourahift. _Q__0113ce He1P,
<br />_ _ $______For____hourahift.
<br />_ o__Aasnyere, _ _ _ $______for____hourehift. _.~__Dfillmen, _ ~
<br />1 ! - _ $~__=_for_b__hourahift.
<br />~ __o__Electricians, _ _
<br />$______for____hour-shift. __Q__Wntchmea, _ _ $______for____hourahift.
<br />---------------- - $------for----hour shift. ----------------
<br />! ~, _ _ $______for____hourahift,
<br />i. I ;, Average number of men employed thin yenr_ .5 g_____________ ______ _____ _______ _
<br />Ia there n millt____
<br />---------------------------
<br />Nnme of mill _________~,_.~.____ _ _Locntian of mill_~J
<br />' I~ - -------------------
<br />~' ; Chnrneter of mill___a~
<br />-------------------------
<br />----------
<br />----------------
<br />------------------------------------------
<br />Capneity of mill_Ll?_2_L_;~ _ ______________\,Vhen was mill erected_ ~-~c--w_
<br />~ ---- _
<br />--- !_4hA____-----
<br />I ~ Oive list of buildings, tramways and other surface improvements ~c
<br />---=Y==--'- - ---
<br />ii -------- _ ___ 7"
<br />I j Coat of surface improvements made in 191! _ _ _ _ _ _
<br />~, ___
<br />' I State amount and character of underground development: 8a
<br />+ ~, ~ Total Development
<br />-- Amonat Done in 191'
<br />!I Shafts __~______ _
<br />i,
<br />i I '~~.. --------------ft. __ft.; cost per ft., $----------
<br />ZVinzes __o__---_----- _ ft.
<br />iS--------- -- -----~'-----ft.; coat per ft., $----------
<br />! !'!.I Drifts _ ~.2~-4. ~
<br />'I I'S -------------~ ----ft. ------- --ft.; cost per ft.,
<br />~~ ~ Croeacnta _J__ $----------
<br />-~tr__~~-• ------- ~ft.
<br />r , ------_-__ _ft.; coat per ft., $___
<br />I, $ave yon reported to this department all Yatal and non-fatal accidents occurring to workmen is the
<br />,f I V
<br />' I' I' twelvo months preceding the date aY this report, as regnired by lawl ~ _________
<br />I ''.'I
<br />i, i' ~ ------------------ -----------
<br />-----
<br />• !' ,
<br />~ Signed_K~~ - _-----
<br />'~// ---_--Company.
<br />1
<br />' ~ ~'
<br />~!
<br />E `i ' sy - ------------------
<br />,:
<br />~I T,ue-----
<br />•, -
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