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If You hate giren a Isaac to others for all or part of the pro art <br />aaowar r. Parries, pttrtncrships or individuals: <br />P Y, state tyre nnmvs of the Ieasiag tom. <br />?~nmc <br />- ~• ~ . JOhIIBAII . _-. 11Inanser <br />I'. O. Address <br />- - Oclo <br />--- ------- - radC_$nri <br />----------- -- ----- -- - ABaa _.Q010a-- <br />------ <br />---- ---- <br />Is prnpcr7r war).ed contimroualY^ --- -°----` ---- <br />--YstO_-------- -"------ <br />If work has Lean stnpped•state whcn_-_- _ <br />5nmc. tills and address of person in charge of trod; for vou____-- --------`-------------._---- <br />_E-_E. EgbOe ~Fti._ P,__ _ ----- ---------------------- -- <br />Surh• the chnmeier of ore-_ 0 9. ~_ ~1~ ----------------`--'----- <br />ommon ~o '--Cr_ip.~1Q_~4~ <br />--- ------ .i_~4~.4,-- <br />State tlrr vufur of the ore___~L~ ~'~ZC-02'lCY. -------------- <br />------ <br />'------ - <br />- -- <br />$o. Emp]nPed hf$!`I EIlf1'L01'$D -~ ' ,. ---- - <br />•-•r -lluclrine Drillrnen. A_ _ - ?`o. I:mp)~d <br />-1L•,cl+inr $cl crs, -for. -' _ltour shift, <br />P ~------for. __hnursltift. r - r ~ _ ~------for---- <br />-- --Miners, _ • ~ _ _-- pum • - . • hour shift. <br />- - ~---_ for.--hour shift. ~ymen• _ ~-----_for--- <br />-I-_TimL:•rrnrn• Firemen. _ - _hoursl:ift. <br />• ._ e-----for----hnure)uft. ---- - ~-----for----hottrshift. <br />-I Tr;immcrs, . ---__I3lneksmitha, _ <br />-• .- ~'------for____hourshift. _ _ - g------for---- <br />Orc 5¢rt•rs. - -. Tcamst hour»hift. <br />------for_--_Uourshift, era,- - ~------for__-_ <br />Tnpmcrt. -----I•orerncn, _ itourshift. <br />~- - -for.___hourshift. - ~'____-_for___ ; <br />LaLorers, _ __ - --'>ul~erintcndent, - t¢ttrs}:if`. <br />- ` _for____irourahift. <br />- ~'------for_.-.!rours!:ift. <br />~------ior_. - - ~'-- <br />_lrourshift. - -for----hour si:ifr. <br />--_- ":ie~~triciuvs. - _ ~ _. _bIiltmm~, _ _ <br />---- - ---for_ ...hour-sL•if1. - g-----for_---h~urs!:i''t <br />---~----__ - ~----for_ -..hour shift. -~ ..«-utchme¢. _ <br />j~r,.y;,." nuwl'+'r of tut eu., --'-----------~- <br />- u emplrn~r•d this v • - - ~-----for----hourshifr. <br />;!:,•r„ ., twill^_. _ ~~$ - -4- <br />'~r.rn,. - ~--- ~--. ~ ----'----- - <br />uf null- ---- -. <br />- - - ~0. _ <br />------------- <br />~l:uract,• r ~-- - -----~- <br />-r o.ntill_. _-1~0 -- J.o~•u~io.~ ------- <br />o" ..~~ <br />-_ 11-------- <br />-- -- <br />_- '---- - <br />MONy, _ <br />tui.~_.._ ~ ------~-._.----------..___.._.____----- ---- <br />Uirc li,t of i,uiklin •s, _-----~t~lrca was mill erecled___ <br />---- <br />6 tnunwnvs and oiler surface im , <br />-~AIIB]._ jj0~ -------- ---- <br />~ ~ -821$tt _ t rovements ---- -- . <br />------------- <br />, ----- <br />os. of surfuc,~ im , ~_. <br />__ <br />1 rovcmc <br />---- _ _ <br />nts made in 1'.qa _ ~-------------- <br />Stut,~ nniuunt anti churucter of undert;rouvd develuprnent: - _ - ---------------•---.~__. <br />~-----.IYOLS------ <br />'fotul Development <br />r r:ufts ___- <br />aIY --~`~~--. _ ----Amount Done in 1918 <br />---------ft. <br />2I80 ft.; coat <br />- ---- ------- . _ pcr ft., <br />Drtfls . - ft. ~'-------... <br />- - - -I7II0----- - '---------ft.; coat per ft., ffi___----- <br />Crosscuts . __-726 _ -----ft. --- <br />---- - ----'--ft• ~ --tt.; cost per ft., ffi-_6..'Dp--- <br />~iave }•ou reported to this depnrfrnent ---~-~~ - <br />-ft.; coal per ft., $__$,,~ -- <br />twe!ve enonths precedin nI1 fatal 8nd non-fatal <br />g the date of this re o ~ ~ accidents IIeC~.r~ <br />Remarica:___ P rt, ae regtured by lawf 1'!!a_}~ ~_Lo k'orkmen jn 1Le <br />---- _ <br />------------------- <br />Signed__~Dtj~_~ . ,~$c ~Z.X41'_ <br />--~ ~CompanY. <br />$y---- <br />r ------_ <br />Title- - $~$~i~fcQAQB~s----------- -- <br />