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~i ~~ <br />I` I <br />~I <br />~:. <br />; <br />~'` I~I <br />;' ' .. <br />I If you hove given n lease to others for nl] or part of the property, state the names of the leasing com- <br />panies, pnrtneral~ips or individuals: <br />Name ~Innager P. 0. Address <br />Is property worked contmnouslyP____________n ~' <br />-F `---'------------------------------------------- <br />If worl: Las been stopped,stnte ivhcn__________ J__________________________________________ __ <br />Name, title and address of person in charge of worl: ff yoi~ ____________________~_______________ <br />/^/ ~% - -- <br />----------------------~~=J. lGl!rwv~l~l,--.'~~ Q!._.t.<...,,aU-~..~c ~---'~"_L__-/'- i!_'~~ - <br />State the cl~nrncter of ore-- ~---- ~-_"=-"-`==-'-------------------------------------------------- <br />State the value of lbe orc----------------------------------------------------------------- ----- <br />'~ DIEN EDIYLOYF.D <br />~ No. Employed No. Employed <br />I~ I ~ ~-.-_llacbinc Drillmen, $______for____hourshift. _____Engineers, _ _ _ $______for____hourshift. <br />I ____ \Inebine IIclpers, $______for___hourshift. _____Pumpmen, _ _ $______for____hourshift. <br />' ~ _ r__.lliners, _ _ _ $~ =_for_~__bonrsbift. _____Firemen, _ _ _ $_______`or____hourshift. <br />1;,, I ' _____Tirnbcrmen, _ $______for____hoursbift. _____i3laclamiths, _ <br />_ $______For____haurshift. <br />I _____'Prmnmere, _ _ _ $______for____bourshift. _____Tenmsters, _ _ _ $______for____hourshitt. <br />_____Ore Sorters, _ _ $___..__for____hourshift. _____Foretnen, _ _ _ $______for____Itourshift. <br />i <br />L'l l __..__Topmen, _ .. _ $______for____hourshift. _____Superintendent, _ $______for____hourahitt. <br />_____Lnborers, _ _ _ $______for____honrshift. _____ORice Help, _ _ $______for____hourshift. <br />_____:lssnyers, _ _ _ $______for____hourshift. _____D[illmen, _ _ _ $______for____hourehi[t. <br />_____Electricinas, _ _ $______for____hour-shift. .____\\'ntchmev, _ _ $______for____hourshift. <br />~~, ~ ---------------- - - $------for----hour shift. <br />~p ---------------- - - $--____for____hour shift. <br />~i ~ I i Average number of men employed this yenr____43_x____%s-,________._:-___-: _____________________ <br />~ Is there ii mi111________________________ <br />' Nnmc of mill-----------------------------------l.oi~nlion of mill----------------------------- - <br />-- <br />i i Character of mill____________________ <br />-------------------- <br />,~t <br />11 --------------------------------------------------------------------------------------------- <br />Cupneih~ of mill_________________________-__--_--_\Pben wns mill crected_ _____ <br />'~ i ~ Give list of buildings, tramways and other surface improvements ~~,~ «_c~__ ~,~/,n~c._~.: _0,_2 __„~ <br />~ ------ --~~__~ _c--------------------------------------------- u- / <br />;~I ---------- <br />----------------------- <br />-------------------------------------------- <br />` Cost of surface improvements made in 191:__ _Q-~-~-~_ _ _ _ ' <br />I _ _____ <br />Stutc amount and character of underground development: $ / <br />I ^~ Total Development Amount Done in 191' <br />- ------- <br />___ft.; cost per ft., $__~______ <br />~ i ------------ft.;cost per ft, $----____-- <br />,~ I Drifts -----------------------------ft. <br />--__________ft.; cost per ft., $ <br />~.I, I - Crosscuts --------------------------ft. <br />___ft.; coat per ft., $__________ <br />,~ 13avc you reported to this department all fatal and non-fatal accidents occurring to workmen in the <br />I ~ twelve months eced~i/ng~thc date of this report, ns required by law} __~! _?_~'__ ,_.~,~~ .- <br />' I?emarka:_~~ vJ-.xxen4~Qp - ------------- <br />--- a /O <br />~ ~-¢~ :-- ------- o- - -~ ~ -- --- - -- --------------- <br />- ---- -~ <br />3 -------------- <br />----------------- <br />~~~ . ~,/, <br />~ ~ Signed_(J~_ <br />r~dt_Company. <br />Title__ <br />__ Gh~ _ -----------~ -----=-- <br />i <br />~ t i-, O <br />r <br />