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§ , ~ <br />' I <br />W <br />,a <br />K -~ <br />~_ <br />.: s, <br />r <br />s' <br />". <br />.1` ~~ <br />3~ 9 <br />t~ <br />{ F <br />,,.fQ a~~., t <br />~!~ ~ <br />~~. <br />> , <br />la i ~+ ~t y+ ~ <br />i€ <br />~ ~ Vc <br />r~ )t~ ~~, <br />v 1,,d ia; ~, ~. <br />3 ~ ~ <br />~I <br />C'Z ~ <br />~ f~~ <br />g' <br />~ ~. <br />I ~ C ~.,t <br />~o persons under the age of 12 years ire- employed '. <br />upon the nine. - <br />~ll shafts, pits or other excavations on the pro- ' <br />pert, are not seclLrely covered or fenced. <br />i'o str~n~ers or visitors are s1lo~ed undergraand <br />unecconi;anied b~~ oc~ner or eWplo;*e deputis^_d to accon- <br />1 <br />;.w^y ahem. <br />>11 accidents have been re~~orted to the ::ureau of <br />fines. Line nanai;er.:ent has no blanl: accident reports. <br />'ire does not carry indemr.it,; insurance against <br />aeci3ent or accident insurance i'or employes. <br />?'ine is not a rE:glzlar 1-roducer. Tire y?ropertg is <br />.COr__Gd COntl nU OllSly. <br />T.'onaLer:;ent is not familiar c~ith statutes relating <br />to the o;t;cretion of r~etalliferoi~.e r:dnes. Scud "L1a.nYs. <br />:rol;erty i.s not srL-leased. <br />T~ <br />Report on <br />Comprising $e <br />]4ot ]mown.-_. <br />Lucution B9b~tt: <br />Section __ 12, <br />Nearest Posto(fice <br />Examination Cmnnten <br />Examination Complete <br />Examination Made L~ <br />I'ilad in the lip <br />,.. ~ -~ <br />day of ~ ~. _r <br />_r,- <br />