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{ <br />i~ <br />If yon have given a lease to others for aA or part of the property, state the names of the leasing com- <br />parries, partnerships or iadividnnls: <br />Name 3lanager P. O. Addrea8 <br />----------------------------- ------------------------------ <br />------------------------------ ------------------------------ ------------------------------ <br />---------------------------- ----------------------------- ------------------------------ <br />Is property work¢d coatiauonslyt------------------------- ----------------°------------------- <br />'' If work hnsbeen stopped, state whea------------------------------------------------------------- <br />Fame, title and address of person in charge of work for you_______________________________________ <br />.~ <br />------------------ <br />State the character of ore------------------------------------------------------°--------------- <br />State the calve of the ore--------------------------------------------------° ------------------- <br />' )ffEN EbfYLOYED <br />.~lo. Employed No. Employed <br />____3fnchiae Drillmen, $______for____honrahift. _____Engineers, _ _ _ $______for____honrshift. <br />-__Jfachine Helpers, $____-_for____honrahift. _____Pumpmen, _ _ $______for____honrshift. <br />_____}[iners, _ _ _ $______for____honrahift. _____Firemen, _ _ _ $_______°or____honrahift. <br />_____Timbermen, _ _ $-_____for____hourahift. _____Rlackamiths, _ _ $______for____hourshift. <br />_-___Trammers, _ _ _ $______for____honrahift. --___Teamsters, _ _ _ $______for____honrahift. <br />___Gre Sorters, _ _ S______for____hourshift. ___Foremen, _ _ $______for____honrshift. <br />___Topmen, _ _ $______for____honrshift. ___Superintendent, _ $______for____hoarahift. <br />~ _____Lnborers, _ _ _ $______for____hourshift. _____OfGee Help, _ _ $______for____hourshift. <br />I ---__assaycrs, _ _ _ 5------for____honrshitt. --___Jlillmen, _ _ $______for____hourehift. <br />___Eleetricians, _ _ $______for____honr-shift. ___~Patchmen, _ $______for____honr shift. <br />--------------- _ _ $_--_--for-_--hour shift. ----------_----- _ _ $------for----honrahift. <br />Average number of men employed this year_______________________________.._________-_____-__-_-- <br />(: Is there a milli------------------- ------------------------------------------- <br />Nnme of mill-----------------------------------Locntion of mill------------------------_--__---- <br />Charneter of mill------------------------------° ----------------------------------------------- <br />---------------------------------------------------------------------------------------------- <br />Capacity of mi]]_________________________________~Vhen was mill erected___________________________ <br />Gire list of buildings, trnmwnye and other surface improvementa __________________________________ <br />Coat of surfnee improvemeate made in 191___ _ _ _ _ _ _ _ _ _ $______________________ <br />State amount and charnet¢r of underground development: <br />Total Development Amoant Done in 191,,3 ~1 <br />Shafts -----------------------------ft. ------------ft.; coat per ft., $---------- <br />~Viazes ----------------------------ft. ------------ft.; coat per ft., $---------- <br />Drifts -----------------------------ft. ---------___ft.; coat per ft., $---------- <br />':' Crosscuts --------------------------ft. _---------__ft.; coat pcr ft., $-----_---- <br />~', $ave you reported to this department all fatal and non-fatal accidents occnrriag to workmen in tha <br />i{ twelve months preceding the date oL this report, ae regnired by lawt ________________________________ <br />i <br />~: ltemarka:-------------------------------------------------------------------------------------- <br />~. <br />~t <br />11i ----------- -------- ---------------------- -------------------------------------------- <br />Signed----------------------------------------Company. <br />By------------------------------ - - -- <br />RStle-------------------- <br />