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a. .- -._ - ----- i ~i: ~; :~ ~~~~ ~~~ ~ It yon have given a lease to others for all or part of the ro a elate th i P p rty, a names of the leasing com- panies, partnerships or individaale: ~, - ' Name Dfanager P. O. Address ------------------------------ --------------- I I --------------- ------------------ ------------ j ------------------------------ - ----------------------------- ------------------------------ } ~, i' TB property worked coatinnonalyf________y! Q___ _____ --------- --- ----------------- ,~ I i If work h¢s been sto ~ Peed state when----------- --------------- ~~-- =---- ~/- !~ ---------- ' ' ~ ~ Namc, title and address of person in charge of work for yon_______________ -- - -- - -- ---- ----------- I1. State the character of ore- -------~ -------------~~~_~~/ -~_--~~,~ - ----- ------- ---- ------ , tote tl~e valve of the ore_________________ --------------------------------- r 1 I ~ ~~ --------------------- h~J ~ bfEN Eb1YLCYED f ~ No. Employed No. Employed ' i ----bfachine Drillmen, $______for____honrshift. ___Engineers, _ _ ----- ' 'lfachine IIelpere, $______for____hourshift. Pnm men, ; ----- P _ _ $______for____honrehift. ~, ~ _____bfiners, _ _ _ $______for____hourehift. _____Firemen, i __ - - - $----- °or__--hoarahift. j ~ ___Timbermen, _ _ $______for____hoarshift. ___Blnekemiths _ _ $______for____hoar shift. ' '. ,; ___Trammers, _ _ _ $______for____hoarshift. _____Teamaters, _ _ _ $______for____honrahift. I~ ) I' ---__Ore Sorters, _ _ $______for____hourshift. ___Foremen, _ ' I ~ II~ Topmen, _ _ - - $------for____honrshift. ' III ----- _ $______for____honrehift. _____Snperintendent _ $______for____honrahift. i ~ i , _____Laborers, _ _ _ $______for____hourehift. ___A(Hce Help, _ ~ j i ;} __-- Assayers, _ _ _ $______for____hourehift. _____blillmea _ - _ ----__for____honrshift. I ' __F.Iectriciana, _ _ $_ $------for____hourahift. ' ~ --- _____for____hour-shift. Watchmen _ ~ ' ~~ ----- ~ ____for____hourehift. I' - $-- ~ ~ ' i -"- ----------- - $-- for____hourshift. 1, I - ---- '--------------- _ $-_____for____hourahift. ~,~. Average number of men ployed this year____________________________ I' >. I Is there n mill i__-- - -------------------------- -- ----------------------------- --------------------------------------- („ Nnme of mill______ ___l __~______ -. i f Location of mill_________________________________ i; Character of mill------- ~ ~c~w ---------------------------------- I ----- j~, ~ ----------------- i-- ------------------------------ ~i' ~ ~ Capacity of milh_ l __~_~_~iu,~-~ - ----------------~'Vhen w¢e mill erected______________________ ____ Qive ]ist of bu' - I~ I ~ , tramways and other surf¢cc impr vemente _ __ 'r. ~.. 1- ~/~~' ---- ! ) ;;; Coat of rface improvements made ~a 191___ _ _ ------ ~~' State amount and character of underground development: $ ' Total Development i _ _ _ _ Amonnt Done in 1913 ~ ~1 ~ Shafts -----------------------------ft. II Winzce _____________________ --ft.; coat per ft., $__________ _-- ft. ____________ft.; coat per ft. ,II Drifts -----------------------------ft. ~ $---------- .!r ~1 ~ ------------ft.; coat per ft., $---------- i Crosscuts --------------------------ft. ~ ' ___ft.; coat per ft. $ave you reported to this department all fatal and non-fatal accidents ocenrring to workmen in the twelve months preceding the d¢te of this re ort ae re Hired b lawT _________ 4 y Remarka:~ ----------------------- ---------------------~------r ± ----- 1 /---------r~------------------------- ---------_---------~---~~~5»/r-------- i Signed-------- ! -- ~ c Y_1uL~--C°mPaRY• By- = ----