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1/12/2009 10:55:08 AM
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11/18/2007 12:15:28 PM
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of the property, state the names of the leaimg com- <br />If yon base gisen a ]ease io others for all or part <br />pnniea, partnershrpa or iadisidvala: <br />!game Jfanager P O Address <br />I i <br />------------------------ <br />~i t -------------------- <br />i <br />. ' <br />,; <br />Ij i <br />r <br />~'~ <br />,. <br />------------------ ----- <br />Is proyerty xorked continnonalyt-'----- ---------------------------------------------°------ <br />If xork has been sopped. state xhen____~---.---------- ----- -----~n-----`-~-- <br />1ame, title and addross of person in cbarge of work for yo ___- ~_~---~----^-----------------=- <br />---' --------- fir-- -- --- J ______--~-------------- <br />State the character of ore--- -------------------------- --------------------------------- <br />---- -- <br />State the ya]ve of the ore__~- ~--~~--~ ---~~----------------------------------- <br />S1E_~1 E)f YLOYED <br />moo. tmptoyea <br />_____Engineera, _ _ <br />_____1'nmpmen, _ <br />_____Firemen, _ _ <br />_____Blaekamiths, _ <br />_____Teamstera, _ _ <br />_____Foremen, _ _ <br />_____Snperintendent, <br />_____Office Help, _ <br />_____JIillmen, _ _ <br />_____Watchmea, _ <br />---------------- - <br />g______for____honrahift <br />$______for____honrshift. <br />$_ _ _ _ _ _!or_ _ _ _honr shift. <br />$______for____honrsbift. <br />$______for____honr shift. <br />g______for____honrshift. <br />$______for____honrshift. <br />g______for-___honr shift. <br />$______for____honrahift. <br />g______for____hourahift. <br />$______for____honrshift <br />Aserage number of men emp]oyed this yenr_____`~`!______________________________________________ <br />Is there a millt------- ~~~-------------------------------------------------°--------- <br />;Jame of mill-----------------------------------Location of mill------------_------------_------- <br />Character of mill------------------------------------------------------------------------------- <br />o. Employed <br />____3fachine Drillmen, S______for____hovrshift <br />_____Jfachine Helpers, g______for____honrehift. <br />_____3finera, _ _ _ S______for____hourshift <br />_____Timbermen, _ _ S-_____for____hoarshift <br />_____Trammera. _ _ _ 8______for____honrahift <br />_____Ore Sorters, _ _ $______for____hourshift. <br />_____Topmen, _ _ _ S--____for____hourshift. <br />__ __Laborera, _ _ _ 3______for____honrshift. <br />_____:tssayers, _ _ _ g______for____honrabitt. <br />_____F,lectricians, _ _ g______for____hour-shift. <br />________________ _ _ g______for____hourshift. <br />' Capacity of mi]l_________________________________When was mill erected____________________-____-- <br />Give lixt of buildings, tramways and other surface improvementa __________________________________ <br />Coat of surface improvements made in 191___ _ _ - _ _ _ _ _ _ $______________________ <br />State amount and character of underground development: <br />r~ <br />Total Development - - --- Amount Done in 197+8e~ <br />Shafts -----------------------------ft. ft.;cost per ft, $_----___-_ <br />Winrea ---------------------------ft ------------ft.;cost per ft, $-..-------- <br />Drifta -----------------------------ft. ----------__ft.; cost per ft., $---_---_-- <br />Croeacnta --------------------------ft. ------------ft;coat per ft, $_------_-- <br />$ave you reported to this department all Fatal and non-Fatal accideate occurring to workmen in the <br />twelve months preceding the date of this report, as required by laws ____ _ __________ <br />$emarka:------------------------- <br />',,. <br />
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