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<br />' ( ~ It yon have given a ]ease to others for all or part of the property, state the names of the leasing com- <br />parries, partnerships ar individuals: <br />i <br />Name 1Vlanager P. O. Address <br />------------------------------ -------- --- <br />---- <br />I ----------------------------- -------------- <br />Is property worked continuouslyl_______________________________________________________________ <br />~ If work has been etopped,stnte when_____________________________________________________________ <br />Name, title nad address of person in charge of work for you_______________________________________ <br />State the character of orc----------------------------------------------------------------------- <br />State the value of the ore----------------------------------------------------------------------- <br />bIEN E11fYLOYED <br />No. Employed No. Employed <br />____nlnchine Drillmen, $______for____hourehift. _____Engineers, _ _ _ $______for____honrehift. <br />i __ _llnchine Helpers, $______for____hourshift. _____I'umpmen, _ _ $______for____horrrehift. <br />i _____illinere, _ _ _ $______for____hourshift. _____Firemen, _ _ _ $______°or____honrshift. <br />_____Timbcrmen, _ _ $______for____hourshift. _____Blneksmiths, _ _ $______for____hourehift. <br />_____Trnmmcra, _ _ _ $______for____hourahift. Teamsters <br />I ----- , _ _ _ $______for____hourehift. <br />I _____Gro Sorters, _ _ $______for____hourshift. _____Foremen, _ $______for____hourshift. <br />_____Topmen, _ _ _ $______for____hourehift. _____Superintendent, _ $______far____hourahift. <br />_____Laborcra, _ _ _ $______far____hourahift. _____O1Bce Hclp, _ _ $______for____hourshift. <br />_____~ssnycrs, _ _ _ $______for____hourshift. _____llillmen, _ $______for____hoursl~ift. <br />i /~ _____Rleetricinna, _ _ $______for____hour-shift. _____\Vntchmen, _ _ $______for____hourehift. <br />---------------- - - $_--_--far----honrshift. ----------__---- _ $___---for--__honrshift. <br />©vernge number of men employed tl~ie yenr______________________ <br />Ia there n mi114___________________ <br />------------------------------------------------------ <br />------- <br />Name of mill-----------------------------------Location of mill--------------------------------- <br />Chnracter of mill------------------------------------------------------------------------------- <br />--------------------------------------------- <br />------ <br />i opacity of mill_________________________________When was mill erected________________ <br />Give list of buildings, trnmwnye and other surface improvements ________________________ _ <br />i~ ---------------------------------------------------------- ---°------------------------------ <br />~ Coat of surface improvements made in 191___ _ <br />j f State amount and character of underground development: <br />Total Development 1lmonnt Done in 191 <br />i <br />,, Shnfta -----------------------------ft. <br />--------____ft.; coat per ft., $__________ <br />~Vinzes ----------------------------ft. <br />--------____ft.; coat per ft., $_..________ <br />--------ft. <br />( !: - Drifts --------------------- ------------ft.; coat per ft.> $ <br />Croesente --------------------------ft. <br />-------_____ft.; cost per ft., $________ <br />~ $ave you reported to this department all fatal and non-fatal accidents occurring to workmen in the <br />twelve months preceding the date oP this report, se required by lnwT ____________________________ _ _ <br />Eemarks:-------------------------------------------------------------------------------------- <br />I ------------------------------------------------------------------ --------------------------- <br />I; I ---------------------------------------------------------------------------------------------- <br />Signed------------------ <br />--------- __Company. <br />-------- <br />BY- ~ykyzc __. <br />11 <br />Title__ <br />~4~ <br />.} <br />