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<br /> MINE ID # OR PROSPECTING ID �y# M- 2 2` M
<br /> INSPECTION DATE oO �r� S INSPECTOR'S INITIALS T D67
<br /> OBSERVATIONS
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<br /> arctvpd mo bronze . kerlamled cpt-uteL once l2;me dre,,ids
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<br /> Ae dPerd�6r ©CS o
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<br /> W!Z1 6/,0- M7140012e fAe aM,>00 rclnL ald
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<br /> +aiIm-�s ma e,ria�
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<br /> her4wceotcS 5!'C'L(eS 9P,pwih . Se6,t'h2L pe;reelnt,2 ( 5r4?5s sPf'6,�f51 00.4 a �>r6s
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<br /> r�lss , O1-C�G1ct►^r�G ,ri�SS,
<br /> (crrtat�ce I3L�re��rSs, ua Sty --,�,4 b,-o 1 e rePte-sco'l1ec�C c4, IMitio'rr uf jfegr 1Wf ve Ct�i�v►'a
<br /> U�C v U �t'� v� r Y W1✓n 7 r S Tuhc�S o r nox;J)a< cvee'l SPcc es CftirsfK?) were owe r vex[
<br /> I & E Contact Address cc: ❑ CE
<br /> ❑ BL
<br /> NAME ❑ FS
<br /> ❑ HW
<br /> OPERATOR ❑ HMWMD (CH)
<br /> ❑ SE
<br /> STREET C 19 WQCD (CH)
<br /> ❑ OTHER
<br /> CITY/STATE/ZIP
<br />
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