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(Page 2) <br />MINE ID # OR PROSPECTING ID # M -17 2-378' <br />INSPECTION DATE I 0 <br />5 <br />INSPECTOR'S INITIALS TOG? <br />OBSERVATIONS <br />o bse rve d atir.L e 4ca is feJ cJu rvr j - 141e ' vi s Pec lioI . No Pole vi 7 d d 1 <br />evrvTroAvoemfc, -C- 1icrzueds were observed rv7f�nzN or rmenec,/a /ely <br />adiaceal f 7o erf4P I sfrucfure. Lnehekc lleQLf, and sine /v rssues <br />-Tor these two structures are rm;hor ;h exfeht Loin's ;rv,rluv ; a natare <br />- -thaw ehcor;rnfered ih the mr6 t. eurL Ir As w'fh +tie mrL1 badLc/1119, <br />74e firs ior7Ga L S'oc vcafy sIiou6.l Provide n Wrrl ine regs-or,QLte ctssurunee -to <br />t/e D V:S7ov% Prr »r' ic, f►naL reiecisse rejard; jocv - t4ese Potell/at. <br />H eeti fi aNd scdety PrdkLeh1 s (4/iI L h e ucle `ZualLy addressed once A ft <br />�aCTL 7�res <br />are released fro recltawicc,frovt re,sPons ;b /� /)' aNcL *uri' eG(, Over <br />"fa fAe 1' /is i ( SbG i e J y. <br />5 WM/1/1 4R <br />J lie MayfLower ALL loaiann_ and assocr fe/ - fac r(rfes, Pl as foe otd <br />Pow r - PLxir, f u hcL MuLe lccro , cao be, released 7"rowa r <br />resPonsi Provided fl f reusahubte assurance ;s Provided 4o fr%e <br />Divrsrar) re3ardDk1 /ow- to Sao Yucato CoahlY � Tstor�C4 L7Cr 7Y W T <br />address the oaTsfuv,clin, heattl and scr(ety coinr_erns discussed rh fire <br />body this report. Ti-- -s 1 d rvzs;oh4 aiic Prs7 "hc'7 heatfA <br />aid Sci- 7 cdnceeAs wrLL becow►e, foie resPahs;6►Lrl of f4e _Sort Juan► <br />Counity f IistorrcoL S acred /once the fries a,v-e re‘eacee and t'lui i,4 $e <br />co &cerms w;LL be a- ,lecuic te(v fuiffern care of by 1k Nrs Soc7ety <br />olurn5 111e Process o - cavrverti I n foie bu:lJ✓t',9s over to h rs fort -c <br />f'ou PurPoseS Whrcln wrtL beg ;'/.1 sortie fT w, e, cafe,- Elie burg's are <br />released b fie Drvrsroi' . <br />I & E Contact Address <br />NAME <br />OPERATOR <br />STREET <br />CITY /STATE /ZIP <br />cc: ❑ CE <br />❑ BL <br />❑ FS <br />❑ HW <br />❑ HMWMD (CH) <br />❑ SE <br />❑ WQCD (CH) <br />m OTHER <br />