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<br />If yon hnva given a ]ease to others for all or part of the property, elate the names of the leaeiag com- <br />panies, partnerships or individuals: <br />Name )Manager P. O. Address <br />L property worked continuonslyt-----y`~rf-------------------------------------------------- <br />If work has been etopped,state wlien___~/_________________________________________________________ <br />Name, title and address of person in charge of work for you_______________________________________ <br />yq <br />State the character of ore_____C..IL~~~f~1.~C~____•_/_____________________________________ <br />b ~ a-u / c~ c~~, <br />State the value of the ore_____JL~__~t~Z__L_G:2_~___~__cY____.f[tJi,~rk~zcyC.L,____ <br />DIEN E3IYLOYED <br />I <br />4 I <br />~i ~l <br />~, <br />~I <br />c' <br />II <br />I: <br />f I; <br />No. Employed No. Employed <br />____\[nchine Driltmen, $______for____hourshift. _____Eagineers, _ _ _ $______for____hoarahift. <br />____:lfachine Helpers, $______for____hourahift. _____Pumpmen, _ _ $______for____honrehi$. <br />_~_3finers, _ _ .~$_`_`'_`~for_~hanrehift. _____Firemea, _ $______!or____honrehift. <br />_____Timbermen, _ _ $______for____hourshift. _____I3lnekamiths, _ _ $______for____honrshift. <br />_____Trnmmers, _ _ _ $______far____honrehift. _____Tenmaters, _ _ _ $______for____honrshift. <br />_____Ore Sorters, _ _ $______for____hourshift. _____Foremen, _ $______for____hoarehift. <br />_____Topmen, _ .. _ $______for____hourshift. Superintendent, _ $______for____hourahift. <br />----- <br />_____Laborers, _ _ _ $______far____honrshift. _____Oflice Help, _ _ $______for____honrehift. <br />9ssayers, _ _ _ $______for____bourahift. _____1llillmen, _ $______for____hourahift. <br />_____Electriciaas, _ _ $______for____hour-shift. ____~Patchmen, _ $______for____honrshift. <br />---------------- - - $---___for____hourahift. ~,.________________ _ $______for____honrshift. <br />Average number of men employed this yenr____Z!~~-4L ________ <br />Is there a millt______________[~liG- <br />-- ----- -- - --------- ---- <br />Name of mill------------------------ ---Location of mill--------------------------------- <br />------ <br />-------- <br />harneter of mill________________ <br />------- ----------------------------------------------------- <br />Capacity of mill______________~_____-_--------`phen was mill erected__ ~_~_~_____ _ <br />Oive list of buildings, tramtivaya and other surface improvements _~~ ~ <br />~_ ~~~~ dcJi-k~_ ~lO1Gy,-C- <br />~1~ r4.~---------------------------------- <br />------------------------- -- <br />----------- --- <br />---- ------ <br />oat of surface improvements made in 191___ ~ _ _ _ <br />State amount nad character of underground development: JJ// <br />Total Development Amount Doue in 191;y- <br />Shafta -----------------------------ft. <br />----___-__ Pt.; coat per ft., $__________ <br />Y~inzes ----------------------------ft. -- <br />-___________ft.; coat per ft., $__________ <br />Drifts __f ~~--------------------ft. <br />----------__ft.; cost per ft., $_!~G__°-"__ <br />Crosscuts __~ _-- ___-_------_ft. <br />------------ft.; cost per ft., $------ <br />gave you reported to this department all fatal sad non-fatal accidents ocenrring to workmen is the <br />twelve months preceding the date of this report, ae required by laws ____~~~ <br />Remarks:----= ~- ~ ._~ r _/. _ ---~=~-r--------- <br />------------------------------------- <br />---------------------------------------------------------------------------------------------- <br />~ ~ Signed--------------rr--------------------------Company <br />t By---u~~~__ L <br />--- -- --- <br />' Title--- ry~.La_~ -------------------- <br />I;I <br />,, ~., <br />