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l'f,l ; ~, <br />~ i IF you have given a lease to others for all or part of the property, state the names of the leasing com- <br />1 i panics, partnerships or individuals: <br />Name 11lnnager P. 0. Address <br />~I ~ ~' ------------------------------ ------------------------------ ------------------------------ <br />~II' ~ . - --- A` <br />I ' <br />---- <br />I~IIi ~, Is property tivorked coatinuouslyY____________________________________________________________ <br />--- <br />If work has been stopped, state when------------------------------------------------------------- <br />i ~ Nnmc, title and address of person in charge of work for you______________________ <br />t ----------------- <br />i ~~ _ <br />I State the character of ore ____ _______________________ ______________________ _________________- <br />(~ ~.,; ~}'~.~/~ State the vnluo of the ore----------------------------------------------------------------------- <br />-fEN Eilll'LOYED <br />No. Employed No. Employed <br />____llacl~ine Drillmen , $______for____hourshift. _____Engineers, _ _ _ $______for____hourshift. <br />_____Dlnchinc Helpers, $______for____houral~ift. _____Pumpmen, _ $______for____hourahift. <br />_____11liners, _ _ _ $______for____hourehift. Firemen, _ $________`or____hourehift. <br />_____Timbermea, _ _ $______for____hourshift. _____Rlackamitha, _ _ $______for____haurahift. <br />_____'prnmmers, _ _ _ $______for____hourehift. _____Tenmatera, _ _ $______for____hourahift. <br />_____Ore Sorters, _ _ $______for____hourehift. _____Firemen, _ $______for____hourshift. <br />_____Topmen, _ _ _ $______for____hourahift. _____Superintendont, _ $______for____liourshift. <br />_____Lnborers, _ _ _ $______for____hourshift. _____O(1'ice Help, <br />_ <br />_ $______for____hourshift. <br /> <br />Asenyere, _ _ _ <br />----- <br />$______for____hourahift. <br />_____-Iillmen, <br />_ _ <br /> <br />_ $______for____honrehift <br /> <br />_____Electricinns, _ _ <br />$______for____hour-shift. <br />_____~Vatchmen, <br />_ . <br /> <br />_ $______for____honrahift. <br />---------------- - $------for----hour shift. <br />_ <br />---------------- <br />_ $______for____haurshift. <br />Average number of men employed this ycnr________ ____________ <br /> <br />I ______ _ _ <br />s there n m~llf-------------------------------------------------------- <br />------------------------ <br />Name of mill-----------------------------------Location of mill---------____-- <br />------------------ <br />harneter of mill---------------------------------------------------------------------------- <br />--------------------------------------------- <br />Cnpncity of mill_________________________________R'hen vas mill erected___________________________ <br />Oive list of buildings, tramways and other surface improvements ____________________________ <br />------------------------------------------------------------- <br />----------------------------- <br />------------- <br />-------------------------------------------- <br />Cost of aurfnce improvements made in 191___ _ _ _ _ _ _ <br />State amount and character of underground development: $ <br />Total Development Amount Dono in 191a'f< <br />Shafts -----------------------------ft. <br />-------_____ft.; coat per ft., $__________ <br />ZVinzes _____________ -----___Pt- ------------ft.•cost er Pt. <br />------- <br />Drifts --------------------- ~ P , $---------- <br />________ft. ____________ft.; coat per ft., $ <br />Croescute --------------------------ft. ---------- <br />---_________ft.; coat per ft., $__________ <br />$nve you reported to this department all fatal and non-fatal accidents occurring to workmen in the <br />twelve months preceding the date of this report, as required by lawT _______________ <br />Remarks:------------- ----------------- <br />,'I ~ Il , i ----------- ----------------- ----- <br />'f y i ~ ;, <br />.. <br />------------------------------------------ <br />Sigaed-------------------------- <br />--- -----------Company. <br />By--------------------------------- <br />