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A~. G D <br />-o:a:~s yi <br />FT O <br />~~~o <br />•~ ~. <br />IMlO <br />RICHARD D. LAMM <br />GOV[RMOR <br />~~RADO DIVISION OF Mt~ <br />DEPARTMENT Of NATURAL RESOURCES <br />1845 Sherman Street. Denver. Colaado 80203 Telephone 892-3401 <br />Norman R. Blake. Director <br />Coal Mine Inspection <br />OPERATOR'S MONTHLY REPORT <br />y <br />For the month of .%~i~, /. 191( <br />iii iiiiiiiiiiiiiiii <br />Mine ~l,r r I ~ l•~i% Address /; ~i~ y - lei/ (, it/c County /'r T/ <br />Names of: Superintendent ~ /, /c ~ /r, Mine Foreman ~ r ••'i ~ ~ ~ ~~ ~ ~c <br />-, <br />Company ) ~ ri,L :~/~,~,.,~ ~;,, Address ~ ~ I~• ~~n~~~ ~'~% <br />Aten Em to ed Ma <br />-H Da T <br />tal <br />Surface Underground Total n <br />ours <br />Worked ys <br />Worked o <br />ProductFUn <br /> <br />All accidents of one day or more lost time must be reported. <br />Date Name Cause of Accident Time Lost Due To Injury <br />Signature <br />This Report Is Due In This Office By The 15th Of Each Month <br />CMI 5 (Rev. 10-75) <br />