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If you have given a ]case to others for all or part of the property, state the nnlnes of the leasing com- <br />panics, partners}lips or individuals: <br />Name Dlnnagcr P. O. Address <br />~ <br />_ <br />I <br />k <br />d <br />i <br />l <br />y! <br />_ <br />_ <br />e property wor <br />cont <br />nuous <br />y4__ <br />e <br />------ --------------------- -------------------------- <br />l <br />If work has Uecn stopped, state when___~/-+~f__ _~.p~~------------- -------------------------- <br />Namc, title and address of person in cllnrgc of wor k for yott_____________ __________________________ <br />' Stntc the chnrnctcr of orc------------------------ --------------------- -------------------------- <br />t~ ~ <br />SfRCC t11C Vn1nC Of tIIC OM________________________ <br />~, <br />_____________________ <br />__________________________ <br />~ itIEN E-I YLOYED <br />a <br />• mployed <br />No <br />~ <br />No. Employed <br />_ <br />\inchine Dril]men, $______far___-hour shift. ____-Engineers, .. _ _ $______for____hourahift. <br />' ~ ___.._\lnchinc Helpers, .$______for___..hourshift. _____Pumpmen, _ _ $______for____hourehift. <br />I _____S[iners, _ _ _ $______tor____honrshift. _____Piremen, _ _ _ $_____ °or____hourehift. <br />_____Timbcrmen, _ _ r______for____hourshiCt. _-___i3laclamiths, _ _ $-___-_for____hourshift. <br />i <br />' _____'Prmnmcrs, _ _ _ $______for____hourshift. <br />_____Tenmstcrs, _ _ <br />_ $__-_--for____hourshift. <br />I! _____Ore Sorters, _ _ $______for____henrshift. _____Poremen, _ _ _ $______for____hourshitt. <br />_____Topmen, _ _ _ $-_____for____hom•shift. _____Supcrintendent, _ $______for___-hour shift. <br />__.__Laborcrs, _ _ _ }"______for____hourshift. _____OIHcc Help, _ _ ~______Cor____hourahift. <br />' __.....:\ssnycrs, _ _ _ r______for____hourshift. _____lIillmen, _ $______Cor____hourshift. <br />_____I'sleetricinns, _ _ :~______for____hour-shift. ____1\'ntchmen, _ _ :$______for____hourshift. <br />'~ ---------------- - - $------for----hour shift. ----------___--- _ _ $------for----houraltift. <br />~.~ ~ Average ntunhcr of men mnploycd this ycnr________ <br />' _____________________ __,-________-________ <br />--- <br /> <br />~ Is there n mi114___ y-~P_ ___ - <br />r <br />___________ <br />(a ATnmc of mill _~:-~c5[---9=? u?-r `-----------Location of mill_ ~•~!_~~~-~.~ .• <br />chnrnctcr of mill--------------------------------- <br /> <br />I ----------------------------------------------- ----------- <br />- <br />----------- <br />---------- <br />------------------------- <br /> <br />------------------------- <br />--~- -- <br />Cnpncity of mill__S~ G_~~~_____ __________ __\\'hen tuns mill ereeted__ ~~_?-?~!1__1~~; s____ <br />Oive list of buildings, tramways and other surface inlprovementa _~r~_ ¢_ ~~tit_^=ct•__ ~~_c__ - <br />----------------------------------------------------------------------------------------- <br />Cost of surface improvements made in 191___ _ <br />Stafe amount and chnrnctcr of underground development: <br /> <br /> <br />Total Development Amount Dona in 191 <br />Sllnfts -----------------------------ft. ------------ft.; cost per ft., $---------- <br />\\'inzes ----------------------------ft. ------------ft.; cost per ft., $-..-------- <br />Drifts -----------------------------ft. ------------ft.; cost per ft., $---------- <br />Crosscuts --------------------------ft. ------------ft.; coat per ft., $---------- <br />$nve you reported to this department all fatal and non-fatal nccidente occurring to workmen in the <br />twelve months receding the date this rp~port, as required by 1a1v4 -_ ~-~-' _ <br />----------- _ <br />Romnrka:_ _ __ ~`w ~~~ <br />~ p <br />----- ------------------------- ---------------------- --------------- <br />Signed------------ --- - ------Company. <br />- -- <br />By-----~-r°r ~- - <br />Title----------------------- <br /> <br />