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I, " I ~
<br />- ~ I it I
<br />i;~; ~ i, L! you have given a lease to others for all or part of the property, slat the names oP the leasin
<br />pastes, partnerships or iadividunla: B com•
<br />~ I ' I Nnme
<br />t Afnnager P. O. Address
<br />(I~ i I II
<br />----------
<br />~,~ ~ ,~I ---------------------------
<br />- -----------------------------
<br />i I --------------------
<br />I ----------
<br />~,.. ~: ~
<br />-------------------~---,f ~-- -------------------------
<br />`Ifi - -
<br />1 ____
<br />---------------------------
<br />~ "' Is property tivorked continuouslyf___________________ \1 '
<br />' I ~~ _.._________________ ___
<br />' '~ ~ If work has been sto \ - ---`-"--'-------
<br />' ~~ PPed,state when-----------------~------------------------ __
<br />" ; Name, title and address of person in charge o,L, work for
<br />~ fin---------------------------
<br />\ 1 ------------
<br />n e tte c nrneter of orc____________________
<br />i State the value of the ore___________________
<br />~~ , ~ ~ _ -
<br />I ~ ii EJIYLOYED ---
<br />' , ' No. Employed ~,~
<br />I I 1 No. Employed
<br />~___lfachine Drillmen, $______for__.._ho ~ eft.
<br />___Enginecra, _ _ _ $______for____l~ourshi[t.
<br />':' _____lInchine flclpers, $______for___ h ift. _____Pumpmen, _
<br />_ _ $______for____hourahi[t.
<br />', ~ Miners, _ $______fo \^~
<br />' j -----~ r_~_hourahift. _
<br />Prnmmrrs, _ -----Firemen, _ $_____ °or____hourshift.
<br />, Timbcrmen, _ , io r shift. _____
<br />$---'-'f ' I3lneksmitha, _ _ $______for____hourshift.
<br />~ ~ - - $------fo~~ourshift. _____Teamstcra, _ _
<br />Orc Sorters, _ - $------Por____hourshift.
<br />----- ------for----ionrshift. -----
<br />foremen, _ _ $______for____hourahift.
<br />1 I -----TOPmen, - - - $- _ or----hour shift. -----
<br />-- Superintendent, _ $______for____hourshift.
<br />_____Lnborera, _ _ ~ $___ ~o~____hourshift.
<br />~ -____Oflice }Ielp, _ $______for____hourehift.
<br />_____Assnyera, _ _ $_____ °r____hourshift.
<br />~ 1 _____.lIillmen, _ _ _ $______far____hourahift.
<br />' ==_-=Electricians, . ______fo ___hour-shift. ____
<br />\Vntchmen, _ _ $______for____hourehift.
<br />-~- $- ____for__ _hourshift. ________________
<br />- _ $-_____far____honrshift.
<br />' "j' i Average number of men employed this e
<br />~' ~ y ------------------------------------------
<br />it I Is there n mi114------------------------------------- -----------
<br />I, -------------------------------------------
<br />Namc of mill-----------------------------------Location of mill-----------------------------
<br />Il Character of mill_______________________________ ____
<br />;• ~ I ,
<br />~ i -------------
<br />Ii -----------------------------------------------~--------------------------------- ------------
<br />Capacity of mill ______ _________________________When w¢a mill erceted___________ _______---_ _--
<br />I
<br />al; ~ --------
<br />' II ~' ~ Oivc list of buildiage, tramways and other surface improvcmcate _____________ ______ _____ _ _ __
<br />Il~li}, ~ --------------------------------------- --
<br />I ~ ------------------- ________________
<br />-----------
<br />I'!' ~ Coat of surface improvemeata made in 191___ _ _ _ ------------'---
<br />,~i' ~i -
<br />.~4+ ~ _ _ _ ______________________
<br />State amount and chnrnetcr of underground development: $
<br />`I ~ I,, I Total Development
<br />Shafts _________ _ Amount Done in 1~J7,2yL
<br />!i, - ------------- ---ft.
<br />ii I~: Wiazes -------- -------- -ft.; coat per ft., $----------
<br />1 ~i ~~ ~~~ --------------------Pt.
<br />11 ~ Drifts ____________ -----------_ft.; coat per ft. $
<br />~ ~ -
<br />~ j' ~,
<br />f~ -----------------ft. ------------ft.; coat per Pt., $----------
<br />, ~ I Croeacute --_-- -___---
<br />1, ---------------------ft. --- ---ft.; coat per ft., $---
<br />1 r •i ' il' $nve you reported to this department all f¢tnl and nos-fatal nccideata ocenrring to workmen in the
<br />~~~ ;, 1'? ~ II`j twelve months preceding the date oY this report, ne regnired by ]nwt ________
<br />{ 1{I
<br />i !I `, ~ I i Remarks:-----------
<br />-------------
<br />------------------------
<br />' !~ ! ,1;; -------------------- ---------------------------------
<br />1 _________ __________________________
<br />' ) ,
<br />-------- -------------
<br />________________________
<br />I i
<br />I' Il ~ ____________________________________
<br />~ I ~) ~. _________ _______
<br />; i _ 6ned~ _ ~~~/j~,,~~~~/p°
<br />I ' 1 , By-'~~=-`j~ ---Company.
<br />i ~
<br />r?~ ~'- ----------
<br />Title------ - --- - - ---- -------------
<br />~~
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