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If yon have given a tense to others for all or part of the property, state tlce names of the ]easing com- <br />panies, partnerelcips or individuals: <br />Name illnnager P. O. Address <br />------------------------------ ------------------------------ ------------------------------ <br />Is property ~vorlced continuouslyi_~~ ~~- ~"C~_~u_-,yf ~ <br />-------------------- ------------------ <br />If work has been atopped,state when-------------------------//-''-~---____-JJ77 --------GG~~2 <br />Name, title and address of person in clmrge of work for you..eCY__~:.fi~£.:S.~e___ _ <br />State the chnrneter of ore_~i~fZrle~ltitr~(,,.----'-~-`--~~--~-~/-/------------------------------------- <br />Stnte the value of the ore-----_---O-~~Q___GLal2. U --------------_------------------- <br />IILEN E~IYLOYED <br />No. Employed No. Employed <br />____.linchine Drillmen, $______for____hourshift. _____Engineera, _ _ $______for____hourshitt. <br />____lllacliine fIelpers, $______for____hourslcift. _____Pumpmen, _ _ $______for____hourahift. <br />_~__lfiners, _ _ _ $ 3 ___for.~ _hourslcift. _____I'iremen, _ _ _ $________°or____hourshift. <br />_____Timbettnen, _ _ $______for____hourshift. _____Illacl:amiths, _ $______for____hourehift. <br />_____'1'rnmmcra: _ _ _ $______for____hourshift. _____Tenmsters, _ _ _ $______for____hourehift. <br />_____Ore Sorters, _ _ $______for____hourshitt. _____Poremen, _ $______for____houreliift. <br />____ Topmen, _ _ _ $______for____hourahift. __./__Superiatendent, _ $______for____hourahift. <br />_____Lnborers, _ _ _ $______for____hourahift. _____OfTice IIclp, - $______for____hourshift. <br />Assayers, _ _ _ $______for____hourehitt. _____llfillmen, _ $______for____hourahift. <br />_____Electricinns, _ _ $______for____hour-shift. _____A'atchmen, _ _ $______for____hourehift. <br />---------------- - - $-_____for____hourahift. <br />q ---------------- - - $---___for____hourshift. <br />Average number of men employed this yenr__?<<_________________ _ <br />-------------------- <br />Ia tlccre n millY____ ____ <br />------------------------------- <br />------------------------------------- <br />-- <br />ame of mill-----------------------------------Location of mill--------------------------------- <br />Charactcr of mill---------------------------------------------------- <br />--------------------------- <br />---------------------------------------------------------- <br />Capacity of mill___________ __ _____ ____________`Vhen was mill erected__ __-__-_-___-_-_____-_-__-_-_-__-____-___-_- <br />Oive list of buildings, trnnnvays and other surface im rovemeats ~7, <br />P _ ~1~ <br />------------------------- <br />---------------------------------------- <br />--------------------- <br />--------------------- ______ <br />------ <br />-------------------------Z <br />Cost of surface improvements made in 191 ~ _ _ _ _ _ <br />State amount and charneter of underground development: $ <br />Total Development Amount Done in 191 <br />Shafts ----------------./_~s~-----ft. <br />---~!~'^!t/ ft.; coat per ft., $__________ <br />- ---e!~z~!V_ft.; coat per ft., $__________ <br />~- Drifty --------------- ~ ---------ft. <br />- ~,u,.~a¢.r.~ Vww ---------___ft.; coat per ft., $-__---- <br />' 6reeaeuts Outl~io P / f?J_~!:„(I=ft, __ p --_ <br />------- 6~i - --~-____ft.; coat per Pt., $__ ~ _____ <br />$nve you reported to this department all fatal and nos-fatal accidents ocenrring to work n in the <br />twelve months preceding the date of this report, as required by Inwt -L_~e <br />emarka:___________ <br />- ------- <br />------------------------------------------- <br />Signed_~~~~_~____~_ ~ i~------Company. <br />------------------ <br />By T~-~ ~~----------- <br />