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If you have given a (sane to others for all or port of the property, state fire names of the leasing com- <br />panies, partneral»pa or individuals: <br />Name .Manager P. O: Address <br />----------------------------- ----- ------------------------ ------------------------------ <br />Is property worked continuoualyR_____ ~ ~!~C___________ __ __ _ _ - - - _ ____ __ <br />If work has been stopped, state wlren____ n `, ~ ~ °L- <br />Name, title and address of person in charge of ~ for you__ ___________________________________ <br />State tl~e character of ore------------------------------------ ---------------------------------• <br />State the value of the ore----------------------------------------------------------------------- <br />11fEN EDIYLOIED <br />No. Employed iVo. Employed <br />____illnchine Drillmen, $______for____hourslrift. _____Engineers, _ _ _ $______for____hourehift. <br />_____1Cnchine IIelpers, $______for____hourshift. _____Pumpmen, _ _ $______for____hourahift. <br />_____D[inere, _ _ _ $______for____houraliift. _____Firemen, _ _ _ $______for____hoarshift. <br />_____Timbermen, _ _ $______for____l~aurshift. _____i3lacksmiths, _ _ $______for____hourshift. <br />_____Trnmmers, _ _ _ $______for____hourahift. _____Tenmsters, _ _ _ $______for____hoursl~ift. <br />_____bre Sorters, _ _ $______for____hourshift. _____Foremen, _ _ _ $______for____lrourslrift. <br />_____Topmen, _ _ _ $______Cor____hourshift. _____Superintendent, _ $______for____hourshift. <br />_____Laborcrs, _ _ _ $______for____hourehift. _____Ctnce IIelp, _ _ $______for____hourahift. <br />_____ASSnycra, _ _ _ $______for____hourehift. _____1lfillmen, _ _ _ $______for____lrourahi[t. <br />_____Eleetricinns, _ _ $______for____haur-shift. _____Wntclimen, _ _ $______for____hourshift. <br />---------------- - - $------for_---hour shift. ~~ ~^ ~ ~ _____--- _ _ $__----for----honrahift. <br />( <br />Average number of men employed this ye___ ______________________ __.______________________ <br />Is there n mi119----- <br />- <br />-- <br />- <br />- <br />------------ ---------- ---------------------- ------------------------- <br />Nnme of mill-------------------------- ------- Location of mill------- --------------------_----- <br />Charneter of mill------------------------- ----- ---------------------- ------------ ------------- <br /> <br />----------------------------------------- - ----------------------------------------- <br />Cnpacity of mill____________________________ ____R'hen was mill erected___________________________ <br />(live li~ b~ ~vny and rf~imp a nta P.,,_____}~_ _ <br />-- (-~.~- -------------------` ----- - ------------------- ,ilk' <br />----------- <br />(jl.L <br />-------------- ---- ~YY1/L~,------ - ---/-` ----------------------------------- ------------ <br />Cost of surfn improvements made in 191_ ? _ _ _ _ _ _ _ _ _ $______________________ <br />State amount and character of underground development: <br />Total Development Amount Done in 1913 <br />Shnfta -------------- --------------ft. ------ -----ft.;coet per ft., $---- <br />----.. <br />Winzes ------------- --------------ft. ------ -----ft.; coat per ft., $---- -- <br />--- <br />Drifts --------------- ------------ft. ------- ---ft.; coat per ft., $------ - <br />Croascuts ------------- -----------ft. -------- ---ft.;coat per ft., $------- -- <br />$ave you reported to this department all fatal and non-fatal accidents ocenrring to workmen in the <br />twelve months preceding the date of this report, ae required by lnwt ________________________________ <br />}iomarks:--------------------------------------------------------------------------- <br />---------------------------------------------------------------------------------------------- <br />------- ----------------------------------------------------------------------------- <br />- ------------------------------------------------------------------------- <br />._ . <br />Signed---~>> `--~ = ==~ =-=e~'-----------=-=-=----Company. <br />1' D1D ~~~[IlI1tQ, ~.illu~l ;,~;uuiiil emu. <br />By------~ ~~ <br />e-------------- u`$~a`'----------- <br />