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~; ~~ I i~: ;Iii I: I P; i i y ~. I ~ ~ ' I 'I ~ L~ , I~ ' 1 I I~~ (~. ~ ~! i. I i I ~ ~', I i ~ it ~ ~ li I I' ~ I I~ ,~ ~ ~~ .1If II,; ~, ~~, j, ~_'' ~it ,I~ '~ II ~II~ ~~ ~ ~ i' I, ~I ~I I I ~ I I I ~t ~ ~~ 'I, ~ , ~I I ,I I~ 1' ~, 1 ~` ~. i ~ { I~ i I ~~_~ ri I~ li I ~~ ~I~ t., ~` ~'~ ~ i. ' ~~(f ~~ t11' '.. If you have given a lease to ot};ers for ell or part of tt~e property, state the names oP the leasing com, ponies, partnerships or individuals: Name Dlnnagcr P. O. Address -------- Is property worked continuously4________ _ _~'_____ _____ __________ ____________ ~ ~- - - - ----------- If wort: has been stopped,sinte when--____/ ~_____________________________________________________ Name, title and address of person in chargL~ o~ work-for you.:__,~_________________________________ ~_ . ~ ' State the character of orc______w_~____c_ ________________________________-__- Stnte the value of the ore------/ ----------------------------------------------------- DfEN EDIYLOYED No. Employed No. Employed ~___Dlnchine Drillmen, $______for____hourahift. _____Engincers, _ _ _ $______for____honrehift. ____Dlnchine Helpers, $______for____hoursbift. _____1'umpmen, _ _ $______for____hoursbitt. _____.llincrs, _ _ _ $______for____hourshift. _____Firemcn, _ $______for____hourshift. _____Timbcrmen, _ _ $______for____hourshift. _____I3lnclsmilhs, _ _ $______for____hourshifl. _____'Prnmmera, _ _ _ $______for____hourshift. _____Tenmsters, _ _ _ $______for____hourshiCt. _____Ore Sorters, _ _ $______for____hourshift. ___ _Forcmen, _ _ _ $______for____hourshift. _....__Topmen, _ _ _ $______for____hourshift. _____Superiatendent, _ $______for____hourshift. _____Lnborers, _ _ _ $______for____bourshift. _____C(licc Ilclp, _ _ $______for____hourshift. _____:lssnyers, .. _ _ $______for____hourshift. _____llillmeu, _ $______for____hourshiCt. _____l;lectricians, _ _ $______for____hottr-shift. _____~1'ntchmen, _ _ $______for____hoursbiCt. ---------------- - - $______for____l~oursl;ift. $______for____hourahift, ---------------- - Averagc number of men employed this yenr_____ ---- ___s!_______________ Is there n mil1P------------------------ -- - - - -------------------------------- ------------ nme of mill-----------------------------------Loaition of mill-------- Chnrncter of mill____________________ ------------------------- -------------------------------- Cnpncity oC mill________________________________ ----------- _ ------------------------------------ _R'hen was mill ereeted n•e list of buildings, trnmtivnys and other surface _______________ improvements _____________________ ------------------------------- Cost of surface improvements made in 191 ___ _ State nmouat and character of underground devel _ _ _ _ _ o $ pment: Total Development Shnfta Amount Donc in 1913 -----------------------------ft. S1'iazes -------_____ft.; coat per ft., $__________ ----------------------------ft. Drifts -----_______ft.; coat per ft., $_..________ -----°---------- ---ft. --------- Croaseuta ------------ft. • coat er ft. ~ P ~ $--------- -------------- ------------ft. knve you reported to this d ------------ft.; coat per ft., $---------- epartment all fatal and non-fatal accidents occurring to workmen in the twelve months prccedia the d g ate of this report, as required by lawT __ ~_%`_~ mnrka:--------------------- ____ Signed_~~~~ Z~~Ef~ ~ ~~ - ---- =~.. Company. Title------__--