https://haylibrary.cvlcollections.org/files/original/f7d4ba233c9799ba11ff4ba49071862d.pdf b6dff2d1c0afd052cde816e4c7457e66 PDF Text Text �Form 123. J; UNfON PACIFIC COAL CO. 111 . _-· Mine No. ,1, OF PERSONAL INJURY. Jt!WO1\ •·······-••• ············ ········· . 8up'ts No. o1 Person i11jured, 11ame '" ?-7 ilCCIIP(ltion, ~ ~ Ollte ~f Accident~~ a z . _ ; _ Loct1i/OII, If no ~ - -r-- ~ t iniured ill Minr, state whlfre, ••••• ••• ••••••··············· l· ·11e79NOo '-=> :ime E / / " ., c..-1.::.,.._ ,,:'_ M/ · o ntry No • / Room o. k, .,,-2,,( F 'J pame of Mine Supt. Age of Person injured, What Family, if any, ~~-~ , _/4_, · / . ~-----4_,Name of Mine Forman, ,,/ · 17 ~ . , ~ - - fAarried or Single " ~--::.VL How long in employ, of Co., / /lame and address of nearest living Relative, Condition of Life or Circumstances, ---- - Was he an ~fficient man,. Where and m whose cha, ge left, ~ 1,/ Name of Physician called, if any, (/ • /7'-;,,f- r _ Was he temperate, ~rq~cf I , ) Cause, /4 (Signature) C-7-tr,.03..011. 7 ~ , ~ - d ~ ~ ~ P' , _, flame and P. O. Adress of Witnesses. Date ,,,d ~ ~ ' Title, c::7--~- �FOl'm 123. ION PACIFIC COAL CO. THE UN Mine No. ,r OF PBRSONAL INJURY. REl'OA / 2 ··············-····--·-----------·------ 1 8up ts No. 1/ame of Person injured, occupatio11, .., r ~ (? ~ ; ~ ····················------• -, .--=-L Date of Accident, ; - tZ,,, ~~ . 190 '3 Time Jo Location, ~ . ~ - - --c:7~Mme No. / ~ Entry No. If not injured in f,fiw, siate where, Name of Mi11e Supt. ..... I ~ C?n(, ;,'- Room No. _:2/ 4.,, · /. ~Name of Mine Forman, ~ . !J/ ~~ Age of Person injured, ¥ y ~ Married or Single ~ - - - ,~ A What Family, if any, - - - ---,, 6 How long in employ, of Co., ,..I ~ Condition of Life or Circumstances, _ _ _ __ _ Name and address of nearest liuing Relative, ~ • .,, ~ Was he an efficient man, Where and in whose charge left, Name of Physician called, if any, ?1/~ Cf-?~~ Wash Name and P. 0. Adress of Witnesses. I t Nature and extent of Accident, ( I Oause, I ' .. I (Signature) C-7-m-oo..ou. 7 ~~ / c;:7' I Date emperate, Title, J - , �STATEMENTS OF WITNESSES. • �- -· -fi Form 123. THE u~ION PACIFIC COAL CO. -- Mine No. REPORT OF PERSONAL INJURY. •••••••••••••••••·••········· 8up'ts No.................................... ~· .~ Person injured, n____fl -- / Name O'J ~ . ~ occupat1011, pl oatc of Accident, ~~ / Location, .., If not injured in f,fint>, state where, cJrv.- ~ ~ 790 \ f ~r Mme No. Time / V q, Entry No. ~ ~oom No. ~~ Name of R1i11e Forman, _r Name of Mi11e S u p t . r / ..2 ,' 3 Cl yq 67, - ~ Age of Person ~n111r , ~ Marned or Single ~~ What Family, if any, _ C7 --.. . . How Jong in employ, of Co., / f" ~ Condition of life or Circumstances, - - - ~ -.·. Name and address of nearest liuing Relative, Was he an efficient man, ~ Was4re tempe~~e,- ~ . Where and in whose charge left, ~ f JlY . ~---;:::J- . 3 ~~ 4. Name of Physician called, if any, Name and P. O. Adress of Witnesses • of2,_,. ( / . " ~ ~ f:_~J v'~~ . ...___ ___ _ • .. k Cause, ~ ~ . .. ,.. ~ (Signature) Date 1 c.,.,..... -··OU. Title, / �~ VNIO~N Form 123. PACIFIC COAL CO. TI-IJ7' 1 RfipOA Mine No. ... ..... .. . .. .. T OF PERSONAL INJURY. 8up'ts No........... ·······-······---· J -?r~ ~~~~ t1/' • .~ Person injured, Namo O'J /J 1//J ).. , . C..P- r.t i //?., _,,,t-<--✓ occ11pat1on, /J - -;<_, oatc ~f Acci~?-.. ~ 1.., ~ ,,,, : .__ -r:- ~ Location, v~ : 7 ~ --r--. . ·ed in Min<', state wffere, ff not tnJUI 190 0 MineNo. Time ~ ;:i. , , , ~ Entry No. µ._ 17 P~. Room No. ~ -y Name of Mine Supt. /4~,/ • / t l ~ Name of Mine Forman, ~~ Age of Person injured, cl ,r~ - Married or Single ~ _· ../J What Family, if any, --~ How long in employ, of Oo., ~ ~ Condition of Life or Circumstances, flame and address of nearest liuing Relatiue, r t , ~ ~ot__;.~,. ~ - - Z _ : Was he an efficient man, ~, . L Was he temperate, .--i;::_-7r Where and in whose charg~ left, {/ ~ -------:z. /~.--( Name of Physician called, if any, < ./:J t- . 0 ~? ...11/: ~ {/ /J 4-J~' , 4 Namo and P. 0. Adress of Witnesses. Nature and extent of Accident, t ( Cause, (Signature) Date 7 Title, _;4 �STATEl\IEN'r S OF WITNf~SSES. J!~.r:. .,,,,, { :' 7 61,.~.~-4_ 0 ~ ru -~-->~-..z- ~.-?:~L ~~~ / , d r - ..L-"., - - k :.c.-' );n,~ , ,7 ,, -.3 . ~ )--o, a.--1--,.... . £ / ~._._.,__ ;t ~ ? YI ~~ ~ '1• .ht• /,., ,, , , ,, .,I..,;...._..;,L_cf ~./ .tt........~c.~✓ ~,,__/ ~ ~~ 7 ,, ~I ---~ a-7 .-d_ £.,j.. . ~- --L ~ /4-r /4 ~ ....:~ ~ -/ -~ .--eL - a -~ ,/ ~ ~ £.._c&.( ~ -=-I' ~ ~ ~ 7-,,,L ~ - ~-~ l"':f.i ,-· . , u...... ~ ~ ~ ~ d I ~ ~~ ~/ , f;Lr11 �TfIE u~roN p ACIFIC COAL co. _ RHPOR , Form 123. Mine No. . . .. ... .. ... , .. T OF PERSONAL I NJURY. _✓5 i Sup'ts No............................ ,-F Person injure~, ,tJ 4,~--,:::.J-llflame 0'I ----;r ~ tJ Occupation, r- / ~· • oate ~f Accident, ~-=--:: Locat1011, ~ : - - • - / j7 If not injured in Mine, state where, /2;:;z~ 190 \3 Mine No. r Time /t1,'::Jc) Entry No. Q, --- ~ Room No. L I Name of t,1i11c Supt. ~~ N a m e of Mine Forman, Age of Person i11j11retl, / fT e- a.. ' "-!.-. Married or Single ' -de---~ What Family, if any, / '" How long in employ, of Co., ..2. ~ Condition of Life or Circumstances, Name and address of nearest living Relative, ~~~ , l ,, d ~ ~~ Was he a11 efficient man, Was he temperate, Where and in whose aharg~ left, # Name of Physician called, if any, c-(!f),t.,.., ~~' 7 ?;::,---:J . iJ;-,-~-'>C - Name and P. O. Adress of Witnesses. ~..---,-£_ Nature and extent of Accident, Oause, __.......::;::L <..__. C-< ✓Cc .-r. L -L ~~ -2.-,,,~-j:yz- ~ CZ,/~✓~ ~ ~ ~ ~ ~ (Signature) t, Date C-7-IG-03..ou. 7 �Form 123. gi vNION PACIFIC COAL CO. T -·-RT OF PERSON AL I NJURY. Mine No................................: ......,/ Jt&PO \ 8up'ts No.........··-··········-·········--·- -d_,~,, .-F person injured, &e..-. . / 11ame 0'J , ;>-'L..~~ • . ?;:>z_._.-;,, ,-,..-<-_,, oacupat ,on, / .1 Accident'p' ~-~-/;;>-c'.., > 1-'.:z__L 190 \3 Time //, '# tJ p /?(, O<de ~' ,,#,,:-/4 ./ V' Mine No. / En-t:ry No. ~ R00tn-A.,,'tJ,-.-.______ Locatt0II, , +r---;:;t:~ If not injured /,{Min", st{{te where, r- 7 . N(lme of Mine ~u~t. t,r.,-,&~ ~ Name of Mina Forman, /&J_ , /JJ -:--... ?7~ , , .V ~ Age oif Person . .1111ured, ;t_ , )7 ,.; ,, Marned or Single );7~ What Family, if any, fi -:.e 3 ~ 7 How long in employ, of Oo. ' / ;?- ~ 1 Condition of life or Circumstances Name and address of nearest living Relative, ~. ~ . ~ ~ 1 Was he an efficient man, ./ , w ,, ? ~ , I,e temperat , ~ ~/ .~ vvas erWhere and in whose charge left, ~</_.e 4 __....,/ (7 , Name of Physician called, if any, ~€. ~- ~ ~~ I Name and P. O. Adress of Witnesses. Nature and extent of Accident, (Signature) Date C-1-11,.03.,on. 1 Title, ~ ' 1 �~ Form 123. THE UNION PACIFIC COAL CO. Mine No. •••••••••··················· ___.,._ REPORT OF PERSONAL INJURY. 8up'ts No........... ....•••••••••·······... , . Name of Person injured, . ~ occupation, ~~ oate of Accident, ,.i' ~ ~ Location, ,~-e-c-=~ If not injured in Mine, state where, d~ 790 -'3 Time Mine No. r a ' ~ q, he.,, Entry No . .J--Lo. Room No. ~ j Name of Aline Supt. ~ . _ . , Name of Mine Forman, ,q'. J ~ , x _ ~ Age of Person injured, ✓J-.J "1 , • Married or Single • What Family, if any, - • How long in employ, of (Jo. , .;i.. ·~~ Oondition of Life or Circumstances, --Name and address of nearest liuing Relatiue, a?~ / ~ , r ~ If?~ Was he an efficient man, rUe-.c.../ Was he temperate, ~ • Where and in whose charge left, ~ • t7 - h Name of Physician oalled, if any, cJ-. ,,,,Y. r-~ . Name and P. 0. Adress of Witnesses. t_ Oause, - ~ / ~cf -~~ -- / ~ ~, ___L_ ~ ---- ~ ~ __,.,__,;c;- ~: ~ ,;,,z, ~ ~ ~ L - - , / ~~er ~---Lz- ~ ---L:-L L . - C - ~ ~ ~ ~ ~ ,,;e:_ ~ ~ ~ ---=---{ ~ r~ (Signature) 1 -·GIi , Title, �STATEMBNTS OF WITNESSES. C J ~ ~ ✓..-iJ, /,,? ~.,_ ~~~, ~ ~~ ~{1 J ~ ~ ? ~ - _:__, L ~u ~ ~ ~~ ~ ~ -~-I ~ ~ ~ ~ ~ ~ . .:rL- --d.._, ~ h---~ ~ ~~ <--,,,_,,,-, / ~ ~~ ~ ~ ~ ~ > A___..,-..a,...~l,4L/ c:-~r ;4 ~ ~ ~~ ,a_~ ~ ~ ~ ~~ , -l �l'orm 123. oNION PACIFIC COAL CO. TrIE Mine No. ,r OF PERSONAL INJURY. pr£POI{ ·······-·················· 8up'ts No... ••••••••••• ··•··········· ,-F Pei·so11 i11jured, ~ ~ Name 0'I. ~ occupation, _ 190-.....3 Time oate of Accident, ~ ~ Mine No. / Location, . ,;,,,•nd in f,1i111•, state where, Jf not 111.J " c7 .. " /4 .-~ , ( Name of Afine Supt. ~ _ , / 'L-e.:,.t....-,~ ,~E.-?,1-t...--Name of Mine Forman, (), b , c;i/o- _/ J . _' / • • f. , ;(J ' -"<Z,.-c;....-,~,.o • dt. ?( ~ • Age of Person m1ure , Married or Single ~~.What Family, if any, -. tf" - How Jong in employ, of Oo., F ~ Condition of Life or Circumstances, Name and address of nearest liuing Relatiue, ~~~ ~ ~ di~ c , ; : was he an efficient man, ~ Was he temperate, ~ : Where and in whose charge left, ~~ ,Jt'~ ~ , Name of Physician called, if any, ~. / . V n . r----;;i- , Name and P. O. Adress of Witnesses. Nature and extent of Accident, [ Cause, (Signature) Title, Date 7 C.7 1r. • •·03--un. �----~- -------- JJ'orrn 12.1. NION p ACIFIC COAL CO. rr·JE U --- J{F,I'O RT occ11µatio11, n _ • _~ _ _/ ~ 8up'ts No................................. ~1: ~ ,., Pei·son i11ju1·ed, Name 0'I Mine No. ................................. . OF PERSONAL INJURY. ~ p oateof Accident, /o~ 790 '3 ime / t:J'~ ~ cation, ,,,_,,,,_-__..,f;.....(..,(....~::i---,,--~ ,,, ~ o • Mine No. ~ Entry No. ~ h/ , Room No. • Lo If not injured in f'Ai111•, stata wI,ere, ------- ~ fl ~ve:. • Name of Mine Sltp;t.. (!"· o f ~ Name of fl/ine FJ>J:111a.n; L ,, __ ~ )_ / / , Age of Person injured, / f ~ Married or f;,,gl;- -7__: ~~What Family, if any, --~--.... How long in employ, of Oo. , ~ ~ Condition of Life or Circumstances, Name and address of nearest liuing Relative, ~ A ~ ~ / {!; I/_ _ ~ Was he an effioient man, ~ Was he temperate, ~~ ' Where and in whose charge left, ~ /4,,I ~~ ~ / ~ ~ . Name of Physician called, if any, o<{l.__, M , v, ti' ••- - - 'J?r' l~ _/ _,. . ,.__.,?_, , JI· ' Name and P. O. Adress of Witnesses. Nature and extent of Accident, ( I I ~'~- , ,, __,,~_/ ~ . A r " " : ·:.--?P L - ~- . ~ ~ .:; ~~~ ~~ ~~ ~ -~~ ~ ~ ~ ~ ~~ ~. ~_,,,cc;, ~ 7 Title, ~ C-~ ~,~-c< ~ 27~ (Signature) Date - £~✓ ~ · • �STATEMENTS OF WITNESSES. I, I I �TilB U.L R8POR T -- J Form 123. NION PACIFIC COAL CO. _ Mine No. ····················-------- 8up'ts No. .....' .................... OF PERSONAL INJURY. ~ d. ., person injured, . ~ . Name o, ~ / / / C/---~,,..,,,occupatiOl1, CJ2-e,,,C-?~ / ..:z., ,, 790 '3 Time oatc of Acci~ . ~~_/ , /4 E11try No. 0 Location, ~.,,,A/"#-' 1/t.::i - ~~ ~ Mi11e No. / . •ured {{, Mine, s'rate where, If not mJ ~ ~~- Room No. I t I me of Mine Supt. Name of Mi11e Forman, _ __ Na Age of Person injured, µ.?_ ~ ~arried or Single ->::>z_~ What Family, if any, ,,#-? - ~ ~ ~ How Jong in employ, of Co., Condition of Lifa or Circumstances, - -Name and address of nearest liuing Relatiua, ;JI.. . Was he an efficient man, . Was he tempera{{ Where and in whose charge left, / ~ ~~ , /h--~ ~ ~ Name of Physioia11 called, if any, ~ - £. ~ . ~ r~ I ./ ~-0 , ~ ,-, ,..~ b ~ . ~ Name and P. O. Adress of Witnesses. Nature and extent of Accident, ~ (Signature) Date 7 (:.7 1· • a-03. ·OH, Title, ~ �-r:' 1'ffr, 11 Form 123. uNrON PACIFIC COAL co. M'1ne No. ....................................... '()u 1' OF PHRSONAL INJURY. pf;/ l{ 8up'ts No.................................... n me of Person injured, 11<l O_J ,,f) / - ~ occupation, ~_...,, oateoJAaoident, c 1 L - ~ /d ~ Location, _!,,P--a--,,,-r::f • If not injured in Ft1ine, state where, --8 190 '-.:i' Time f?.'.a 0 flline No. / Entry No. - ~ ~ ~ Room No. ~~~ Name of Mine ~u~t. • Name of Mine Forman, ~Age of Person m1ured, -2- 7 ~~ Married or f;,,gle ---L _ • .. .P _ What Family, if any, , ~ How Jong in employ, of Oo., c.J - -- - ~ Oondition of Life or Oiraumstances, - - Name and address of nearest liuing Relatiue, ~ . ~ r,. , . , . . . _ ~ _ , ; I~ / was he an efficient man, ~ , Was he temperate, ~ Where and in whose charge left, ~~. of)_ ~ ~ . . . . / c?' - ~ Name of Physicia11 oalled, if any, .d).,._,_ .JC¥'. ~ , d Name and P. 0. Adress of Witnesses. ,,I Ii I Cause, ' I (Signature) Date 1 Title, �j Form 123. , rrON PACTFIC COAL CO. -rJTfi uT., , Rlrf10f, T Mine No. • ••••••• ·•· ··· · ······· · ····---- . !. . ____ OF PHNSONAD INJURY. 8up'ts No................... ........ ··· ···· ,F Parson injured, , .:;;f;' ~ Name o,. ~ occupat1on, -z-L_ 190 '-:3 oateof Accident, ) ~ c:i-r Mine No. . {/1,r,-c..- I~ ~ .c ,11- t"j," ' - / Location, , ,/ rt If not injured in Min,•, state where, Time c~ I <) Entry No. >-J q, >?v, Room No. q , e_ . c..-e,__._ _,:f / 3 L, v~~4- Ae-(/. Name of Mine Forman, ~~~ Name of Mine Supt. Married or Single ~ :t t ~~ Age of Person injured, What Family, if any, How long in employ, of Co., - -· Condition of Life or Circumstances, Name and address of nearest liuing Relative, d'/1-< ~ n 91, Ju:.., /v< p,,_-~ was he an efficient man, ~ Was he temperate, Where and in whose charge left, p-.,...n:- e:- ,,..."--:::1 - ,A 7"1..-4.--e.-a-__e_ ,<70'.'.'.:.--<Z~<--C.. /lame of Physician called, if any, . . . . ____ (/ 'i y-a c( flf Name and P. O. Adress of Witnesses. Nature and extent of Accident, ~ , ; z : , . _ _ - .,,._ _ i>-/--8-/r- t:-(1-l!L.t:A.-A/ 1 0 - ~. t.l r11 s&k,d:L~ /~'-I ~~-~ II I I I I ' (Signature) Date 1 Title, �-r:- vNroN Form 123. PACIFIC COAL co. rflo RfipOR Mine No. ••••••••••••••••·•••··············------ T OF PENSONAL INJURY. 8up'ts No.......................• • •········ ~ c7:.~ .~ Person injured, O f{afllC'J. ---/,.~ occupat1on, ~ oate of Accident, / .:i._~ ~ Location, ft?,,.. c,/4/ ,,A,t--~n- r - ~ If not injured in Mine, state l 71ere, r,~ " 190 3 Mine No. Time /7 / d O ' Entry No. t'L-c.-/ ✓ t?-- C/ )?i,, 1 Room No. / I ~ ~ Name of Mine Supt. /4• Name of Mine Forman, Age of Person injured, e:z-..3 ~ Married or Single ~ What Family, if any, -How long in employ, of Oo., / /'7~ Condition nf Life or Oircumstances Name and •~:t"tof nearest /iuing l l e l a a : , ~ • ~ ~ ,,,l __ ! Was he an e;pcten man, Was he t e n ; : e r •~___,~. ate~, 11 Where and in whose charge left, yt-~ ~ t:7 Name of Physician called, if any, v~c::!(, /,c__,_ ti -()/ ,' ,J !1/-,,-,. ,! :---=- 4 , c:5{~ ~?f'-r,v 4-C--Ce • rd~~/ ,z:.:._~ - ~ - <a../ ~ 7 Cause, --/~ ~ ~ ~ ~~, ~ - ~ ~ r ~,,-,,,_~ L (Signature) Da.te 1 c.,.,~-03--ou. I J Name and P. 0. Adress of Witnesses. Nature and extent of Accident, ?I' Title, ~ I I ' �Form 123. v~JON p .ACIFIC COAL CO. 1'f!£ Mine No. --- • ·--····-····················--- ,r OF PHRSONAI., INJURY. pJif'Ol\ 8up'ts No. •••••·•·· ···-············ ..... Jk-e-- ~~~~ ,F Person i,7!,ifurcd, l{ame O; _~ occupation, ,,,, ~ _ oate of Accident, ) ~ .n /4)t, e- /.2 / rfSZf ,,;·_ ,i • . - , : _ - ~ Locat10 , vr' ~ . ,iured in Mint>, state whe e, If not 111., ~_J-/, Name of Mine Supt. A.e....c • Age of Person injured, What Family, if any, __ 0-o "~ 4 _ _ 790 -.....3 Time Mine No. F Entry No. :;i_ Room No. ;r: O ~ Name of Mine Forman, _!_ 7 ~~. Married or Single ~ - How long in employ, of Co.• -~ Y~ ~ ~ o n d i t i o n of life or Circumstances, - -~ Name and address of nearest liuma Relatwe, 8.--&A....;_.._.,_.c( '1-. ~ , , ~ was he an efficient man, ~ Where and in whose charge left, Name of Physician called, if any, • , Was he temperate; ~ --:fJJ.~ ~ ~ e_ ~ ~ Name and P. O. Adress of Witnesses. Nature and extent of Accident, JI h Cause, ' (Signature) 1 Title, I I �F orm 123. r.fl6 u.N[ON PACIFIC COAL co. Mine No. , , 01" PERSONAL INJURY. Rl~/'0 1\ 1 • • ·················--·-· 8up'ts No................................. . Ln c/ lf' .-rv ~ -~ ~ . , / ,1 Person injured, 0 11ame 'J . ~ a.~ occupat,011, . -~ 0 oate of Accident, ~f_ ~--790 '3 Time / 0 ,- ;;.. 6 Location, ;::i-a-:,t- rr.• ;,e-"', ~ ; : ! ' ~-·. Mine No. I Entry No. 'niiured in Mme, state whera, c..P-/2.,__,c:,_--a. .~ /:_ ~ , t J·,' ;Le -· If 110 I 'J - U q . »(. , , ,' - ~ ~ Name of Mine Supt. Age of Person injured, ,;i.. 7 -~ - ~ What Family, if any, How long in employ, of ao. a:A---~ / Name and address of nearest /iuing Relative, %.--i:f:-- I ~ Room No. £\ /4.-0, - ~7q,,/, / 'I I Name of Mine Forman, Married or Single ------ r~ .JI..... Condition of Life or Ciroumstances, /-'!... . _ ·.,. . &(~ ~ (. ~ #,~-~,,-J AL-~. o6J.v, J. Q . Was he an efficient man, 4?,-, ;{/ Whereandinwhosecharge/eft, /lame of Physician called, if any, , Was he temperate, f l -=--..-t----7>--~ , I I I Name and p, o. Adress of Witnesses. Nature and extent of Aooident, Le..-c...e.- . L"-?7L Cause, ffe -L,,_.; d-a.,,,J T ~ /4....~~ ~ ~ ~ /~ ~ £ =L._ ~ Au /4.. ~ ~ ~~~ ~ - j)l L ,,v ~ -<--fL~ ;z ~ ,,,, / ;,_ ~ ~ /4 ~ -L ~ ly d_ ~ ~ ~ ~ r-rJ_d_ ~~ ~ ,..,a--~. (Signature) c. 4. ~~ Title, 1 m _ , ,~ ,? r ........__ ~ J .A - r, ,_.... iiI I I i I I �rJJ6 c.N[ON PACIFIC COAL co. Fonn 123. Mine No. ... .............•••••• ···- -- . RfipORT OF PERSONAL INJURY. J,,-<----,4 +~ name of Perso11 i11jured, _ ~,{' occupation,. oatc of Accide;J:y \ ~ / 7 ,, / / ~ 1...3 790 Location, ~~~§ n--r -.-Mine No. If not injured m Mm", state where, - --- #- · L-. ~o~ Time / Entry N0 • Y--..3 v,:> >;u - '(· Room No. ~ "1-)- / , ~ Name of Mine Forman Name of Mine Supt. ~ /J Age of Person injured, Marned or Single ~ What family, if any, How long in employ, of Co., / ~ 11dition of Life or Circumstances ~ Name and address of nearest liuing Relatiue, ~~ q ~ ~_/) was he an efficient man, ~ flr -~:• he temperate, Where and in whose charge left, J)/ , # ' ~ ' 7 ( ,<_4 /, Name of Physician called, if any, ;/ , C/,c , ..r ~ pl'7~~ , ' I• ~ J/ 1-:::;;r p~~=-/. :;5~~~/4~: Name and P. 0. Adress of Witnesses. • Nature and extent of Accident, I I Gause, 17 P,d I 1 Title, l �F orm 123. rFIE u~roN PACIFIC COAL co. - --- REPOR T Mine No. • OF PERS ONAL INJURY. ······················-· 8up't s No................. ••••••••••••······ ,£ Name 0'J Person injured, . / /,. 0ccupat1on, .. oate of Accident), ~ ~/. , /,:,,,, / ~ ,, / / / , / , Location, c c . · · ..: l' /.v 1 • .,, 7 , If not injured in Minr, state where, Name of Mine Supt. • d ,,~ Age of Person in1ure ' What Family, if any, r/ '-=', 190 Time Mine No. t fl:-r/ ,, - , / ' a ~ ~ a . -C:/ 1 Name of Mine Forman, _.£0, \..(f)/J v--,.,,t....c~,/ b rG~ - !.-tarried or Single "\ ~ : ,...c a p' ~ ( -a,,,,,--i.-.:.-c-cr , How long in employ, of Co., cf2- p -R a...<-cs.z. -/ Condition nf Life or,,Gircumstances -Name and address of nearest liuing Relatiue, ~ ~ 0(--,. ,,.t'/ , 4.. ~ nWasheanefftcientman, ~ _.?' ~ he tem~ te,, - _ : ~ , Where and in whose charge left, a.L -,;('---,,;;,-~ _ , ~ , Name of Physician called, if any, #,., ~~ . j _.!;t{ q> ..cf', Name and P. 0. Adress of Witnesses. Nature and extent of Accident, C Cause, ~ J :3 , ,::::;"~ _.,,.,~ /~~ ~ --------J ~ ~...-; ~ ./2-o ' / ~ -~z:-L / d' " - - ; /~ I~ U ,3 , ~ ~ --L _,.,.___J ~ --L__,__,, ,.__,, ~ ~ i:/.~, '7."'<4>v~ ~ ~ AM~ 7'7 ,-/ _,,;,,/4;. ~ • L ~ F '7 ;--,,/ .z,L ~✓~ ~ ~ ~✓ ~ ~ ~ 4 q ; ·~ ~ ~ ~ ~~7~, (Signature) 1 Title, .I �Fonn 12:l. N P ACIFIC COAL CO. VZ\IOr rfl 0 ---·-pf.PORT /) _~ ? .1 Person injured, , \_1/ - I"- ( e ,,_ _ Name OJ . t% / /. _.,, "7< / < , / occupation, ?,1Accid~n e- c - - r:f.c... ~ - - / v 0aie OJ . ,,. ~ ,,x. .,( ✓ ' ~ ' - Loeauon, /"' ,n . -Mm,., . stat e w I1e 1.e, .. red If not mJU Nam• of Mine Supt. I ~ ,:- - _ ,,,.. _ Sup'ts No.......................... --::>- ,,,, '-- __;( a_ " -✓ - Mine No. ~ ~ 1 " ,- -=- 190 "-:? ,r..,~L Time 7 "' .,,, "' o ;' , ;- d ,# Entry No. / - ~,CJ , ame of Mille Forman, ,)~ J Where and in whose charge left, Name of Phgsician called, if any, e...--.? ~ f' ~ Room No. J ,1/ --i ,<_ Y ~~ Age of Per~on ~n1ured, J ,,,2- ~~~--z..-<2.-Married or Singfe • ~ What Family, if any, / How Jong in employ, of Go., LZL y- ?,:,,~ ~ ....,_ . c- ~ Condition of Life or Circumstances Name and address of nearest liuing Relatiue, ' was he an efficient man, 18 1 ·····················- ·-- Mine No. oF PERSONAL INJURY. -~ a - ., I • er ~ -I Was he temperate, / ' ~ Name and P. O. Adress of Witnesses. /2- II ' ,,. 'T~ -y, ~, ,. - · --<- C! ..,_.,,- ,,, Nature and extent of Accident, -~ Cause, a<!_ ~-----~__,.../ -a/ ~ -<--~ ~~~/L -~ ,a , L- c ( L . I I ~ I ! ~. (Signature) 1 Title, I �l!'orm 123. N PACIFIC COAL CO. rrIB v.NIO - - - T OF PERSONAL INJURY. J?Ei10R Mine No. ••••••••••••·•·· Bup'ts No............····-------- J -a--d ~ .J/.-~ . .: •••••••••··· , person injured, t::t...-n-J Name o,1 /7' r • ~ - ' - < - ..:z.-C--z2::---,,, ......-z. -✓~.R..• occupat,011, / /} • t1/,, ..--2..~...-~-~ .1 Ac~iden v· r ~.; - ,,,.__~_,_ - · ,._- .,I' ,, 790\.....:;, r: oatc o, ,e r.{ ,me .._-1 0 , c. -t'.., 'C _4. 0 . , . ;,,, 4 o:..-n. Mine No ,., R1 • 1' //~( , Locat,on, 1/ • o<Entry No /, ~ . •ured in Minr, state where, • ..-.;;:i • Room No. - -If not 111} I - ' ..,/1 ~ --L- J, Name of Mine ~upt. fr-<'-'. ~ ~ m e of Mine Forman, /?/, @~ Age of Person m1ured, // Married or Sing¥ , ' What Family, if any, How long in employ, of Co., ,?- ;:-/~ ~rz._..,/ Condition of Life or Oirot mstanoes Name and address of nearest liuing 'Rel~tiue, /J...,,.,, ./ ._X,..-<. ,..,,L- r ~ Was he an efficient man, .r-/4J I'-; , Was he te,~perate, ._..,,.,-~:.-c...-c.-.::i,~<-d? Where and in whose charge left, t7JJ,/-?11..,,.,, ~ ~ Name of Physician called, if any, ~ , J~ Z u /4~C, Name and P. O. Adress of Witnesses. I I ' I (Signature) 7 Title, �ras Form l.23. TtNIO.N PACIFIC COAL co. V '" ---- Mine No. r OF PERSONAL INJURY. Jl6f>OR ••••... ···············•••••··· 8up'ts No. •••••••••••••···· J/-A~~~,,.J J ~ , ~ .,person injured, Name o, ~ ' , occupation, • <- ~C--?--,,-r--y ,....-z ~ ,I Ac~iden (J2r ~~>-~.. •- _ ..._=1 r " oate o, / d =( ~ < -c--c... = - - n r.ocauon, 1/ .. red in Minr, state where, If not ,nJU • " ~ ,,,_ - - ~-~ 790'-...;;, r· ,,me !Aine No ~ (>... • • • ,. ..-< a , e--e..... ..,4_ a ,. • < , »( Entry No / ~ R ' • • oom No. - J, ~~~~--?t.....et.._.,. umeof fl/line Forman, /,l/, @~ ,,.,oJMineSu~t. 6 Age of Person ~n1ured, // _;:-~ Married or Sing¥, ' What family, if any, How long in employ, of Oo.' ;J- / ~ ~ Condition of Life or Circe mstances Name and address of nearest liuing 'flelatiue, _:J,:f._,,_x / Ja--<. "L ~ ,,, h an efficient man, ~ ' /4/, /1.~--?'>c-<-"1:;,.-.-<..A:..-=._.....:.........,,p, ,l 2 "as e Where and in whose eharge left, Name of Physician called, if any, .,,,.._, , _,I) .,. -??<....., t.1/ ~ / -4?,,,, ~, /4~~ Was he temperate, , Name and P. O. Adress of Witnesses. I I II I I I (Signature) 7 >1- ;. ~ Title, ??f, cf - �STATEMENTS OF WITNESSES. ~1 ,.- __._._d . ~ """ (J' !;I,: _,;__ .7..,. )i___;_....;,...._....,.... ~ ; ~ .......----.--, ~ ~ ~ ~- / - -~ ..,,_,e__ ,;l.f ,, - ~ -/ a , _ ~ , p,u>. ~ <Y-U:. >z._,;_.....:,.._...,.__,....,- ~...-.-- .-z:::...,,{___ ___..,/ .zL ~ 1-y ~~ /4Z d _..,...._...__, ~ ~ ~ ~ ~ fll - - L , , ~~ ~ J ~ -~ ~ ~• 47 ~ ~ ---=-L, ~ - J ~~ ~ �THE U Form 123. NION PACIFIC COAL CO. J?EPORT Mine No.................................: OF PERSONAL INJURY. . 8up'ts No.. ....................... .~ Person injured, ( ,~ • Nam e O~ ~ , /?Z.--~~ • occupat,on, - -· 190"'-.:? Time oatcofAcciden~t, ~-~ ~ y " - --Location, - c ...../4 ..-.-·- ,/4- ,_ ,_ -----✓~ ~.. Mine No. / Entry No. ~s 6 If 110t injured in fine, state where, d~- / Room No. c/"9~.J,: ,/,.~__.____../ Nam• of !fine Supt. c : : 1 ' ~ Name of Mine Forman, Age of Person i1,jured, ,. ? t?" ;;t--~ married or Sing/~ 1 What Family, if any, ....-.::::; ~ ,, How.long in employ, of Co., ,,.:i- ~ Condition of Life or Circumstances, --- Name and address of nearest liuing llelatiue, cc...,.,,__~ / ~ - C - . . . . ~ ~ ~L . ' Was he an efficient man, Where and in whose charge left, Name of Physician called, if any, ~/ , Was he temperate, £~✓-/' ~ ~ - L _ , _ - - - - .. ;?f? f t . o;z,.-1'. -<0 ,, . ,,~ V p~ ' .. · ~ °c ~· Name and P. 0. Adress of Witnesses. Nature and extent of Accident, Cause, {JL~· ~ ~ ; ,_;J_ ? J _,._,_~ __,,.__......,,J~/ ~ )z.,, / - «----- cl ~-(,/;>~~ ~ ~ ~ - -, -2j1 ~ .-A-~ b..., - ~ ~._;, ,,,, _d-a-y ~ ~~~.. /7"&?''-s, ~ ~ ~ ~~ ~ (Signature) 1 Lr&~ Title, 'hf, d, �STATEMENTS OF WITNESSES. �~ ✓2 Form 123. N PACIFIC COAL CO. f!IE UiN[O _ Mine No. F PERSONAL INJURY. RBPOR T O ···········---·--·-- 8up'ts No.................................... -1 Person injured, ~--~ Name 0:1_ , ~ ) J~~ ~ occupnt1011, ~ ~ v7 ,____p ' ·d ,nt ....,..... .JL... ,,. -190 -<.. -r· ~ d J . _v ~ , oate o_if Acct/.~'}• , z:-... /?,, ~~ t1me _ Locat1011, /~~7._ 11/ - --7 Mine No. / Entry No. 0 Room No. If not injurltf in Mill", state where, {,(~cf}- ~ - -~ ~ - . ~~ Name of !,fine ~u~Jt. (✓ ~ . , ~--=-- ~ -~ l,~ Name of Mine Forman, - -p' Age of Person ~np,red, / 7 -y-e-~...Y Married or Single 4.,-.,,.__,e-~ 4 What Family, if rmy, 7 ~ How long in employ, of Oo., .J ....;,~ - ~ L _ - . Condition of Life or Oirc,umstance~ Name and addr~ss of nearest liui,(g Relati~ O v-=----. ~~ ~ was ha an ejfic,ent man, Was he tempe,;te, ~ , - ~ - "Y"'· • Where and in whose aharge left, / ~ ~a..2-~ ~ 11 Name of Physician called, if any, c.~ . E . .,/; ~ j': ~ CZ? ' . )/. c. I I Name and p, o. Adress of Witnesses. I Nature and extent of Aooident, Cause, (Signature) Date 1 II. ~ Title, ~,r~ ~ ;,d_yC , �ll'o1·m 123. ION PACIFIC COAL CO. THE UN - RBPORT - - Mine No. OF PBRSONAL INJURY. 8up'ts No. ., person injured, %,,..,.._,., ~ Name o,. fa- •-tf'--c:- ~ ~ ,.)~ ~ - - - ~ Occupation, 7/2 ~ . 3 t of Accident, pbU~~ --.-c( 190 -3 Time / ,i.. ,:, ,~~ p ??'(. ::c:tion, Mine No. / Entry No. Room No. If not injurtd in a1in11, state where, ( ~ - - - ~ ~ . ~ ~ 7 ' ~ / 4;(~L ~~ ~ Na,,ie of Mine Supt. a/-"-?"- ~_:_/-<2./' Name of Mine Forman, Age of Person injured, i/.,,t. ~~· . Married or Single ~~ What Family, if o11y, /7,7-e_ ~ / / ~~ How long in employ, of Oo.' .,,,2- ;2. o/~___..,,-; Oondition of Life or Oircumstances, _ _ Name and address of nearest liuing Relatiue, ~ #.-....._.,/ ~ • ~ i,..~ _/ Vias he an efficient man, ~ , Was he temperate, ~~ - ' t ' Where and in whose charge left, # ~ ~~ , /Name of Physician called, if any, ~ . n<l2r_.~ '"-<--.,._,.- --/. Name and P. o. Adress of Witnesses. .I ~ (Signature) Date 7 c-,.15-oa--ou Title, CIL-;-z~, ~ +· �STATEMENTS OF WJTNI•:ssBS. ); • : .• I• ' , (1 • • ' , rl I t. '-/ r / �Form 123. ON PACIFIC COAL CO. TSE u~r Mine No. OF PERSONAL INJURY. RJSPORT 8up'ts No.......···-- n~ &~ ·~ 1 Person injured, Nameo_ oacupat1on, oate of Accident, . 11 ······················-··· /J . G~ • J d"T!'....k./' ~ a & . ~ ~ .;i.. _ _ __/ Lncat/0 , . . red in Mine, state where, If not 111]U ,_,, • 190.J Time Mine No. / o Entry No. .z ~ ··········:···· 'r u?~ Room No. cf}. {?~ N(tmc of f,fi,1e Supt.~~ Name of Mine Forman, )f Age of Person injured, '-~ d ~--a-<--0_,,.-_ Married or Single .~" What Famif!f, if any, / •/ --.. How tong in employ, of Oo., y- - - ~ Condition of Life or Circumstances, .___ __ _ Name and address of nearest liuing Relatiue, fr~ was he an efficiant man, ~ . Was he temperate, ~-e..e--Where and in whose charg~ left, /1-1;;)-,,.., ,.; ~~~ # o / ~flame of Physician called, if any, f, _,,,,-;{f/_,,,_, .-....-:. y ~- ~ >-,_( 1 Name and P. O. Adress of Witnesses. C Cause, L-~~ , ~ ~ ~ - ~/ ~-~~ -~ , ~ -4~ ~~ (Signature) Date 1 ► �F orm 123. THE uN rON PACIFIC COAL co. REI'Ol~ T Mine No. .......................... ······-----~ OF PERSONAL INJURY. 8up'ts No. ······················-· d( .~ Person injured, '")/ • Name O'1 . /n~t,,.; i-e/V occupat1011, tc' / / //".z-L_ Date of Accident, _ l.,__ .:.-- ;,-,,,-, ~ , • 190 ....3 Location, -// ~ r Mine No. If not injured in fAinc, state wffere, L((_ ,,,., 7 ,. Name of Mine Supt. ,d_...,., · Time ~"': (,g!~,{_ Nnme of Mine Forman, ) , ~. Married o/Single £ A)~ - ~-ee Age of Person m111rad, ,?- f" ~ What Family, if any, ----· How Jong in employ, of Oo., ~ f da.y~~l./ondition of Life or Circumstances, , !Jame and address of nearest liuing Relative, 77/, ~ _.,...--e.. ~ ~ 1 Was he an efficient man, ~ . - -- ~7a'; he temperate, .--?/~. 1 Whereandinwhosechargeleft, ~ ✓c.,LJ .,..;~Y~ ~. Name of Physician called, if any, vDf," / 4 . , ~ ~ c : ( -,,------___,J _ JJ/-~J/ -z;;-~ Name and P. 0. Adress of Witnesses. Nature and extent of Accident, ~"-'("- ·✓ ~ Cause, ~ ~ "'-- I .-a,/ ~ ~ ~ .,._,.,/ / a-,& .=L_ ~ ~ 7 ~ ~.,, ~~~~~~ - 4 ~ , ~ ~~ ~ L ~ -=-~c-( ~ ~ ~ __,;,_, ~ ,,,d ~~ 4?'L-~ . ~ ~ ~~/~~ ~ ~ ~ (Signature) Date 0-7•t:H>3-•0U, 1 Title, /z;, /4 ~ �STATEMENTS OF WITNESSES. �~ Form 123. ON PACIFIC COAL CO. TJIE UNI Rb'P0R Mine No. T OF PERSONAL INJURY. 8up'ts No. Name of Parson i~jured, , occupation, fr{;jr:_ oate of Acct,:;'dent , <=....<._.-~{.,/ Location, . ""~ / . 'yIf not injure 111 !11111<', state where, ~ ~ ¢~~ ,~,,__,,._.,,,..-.,___,,....,n 19fT'.3 / ~ , Mine No. Time /,,, ...3 o / Entry No. ff"~ o ~ v? AA. 0 Room No . .;>_ ;-,,..- r {i2. Nam• of Mine Supt. -Y ~ ame of Mine Forman, Age of Person injurer!, ,~:;,;~ - -:, _ 11/arried or Single d~~ What Family, if any, ./ ~, ,,___~ / - ' How long in employ, of Co., f7 --:;;::,, ,_,,,_.~~- Condition of Life or Circumstances Name and address of nearest liuing Relative, ~~ ~~ Cft~~ Was he an efficient man, Where and in whose charge left, Name of Physician called, if any, ~r/ ...__,,-::, , Was ~erate, ct? ,.~ ,' ,/4-.,_~ o<fJ-v, , 1"'1/~ ' ~£_L/,, __ -- ---y' a < O ~~ Name and P, O. Adress of Witnesses. Nature and extent of Accident, , l { lJ 1 (Signature) Date 1 C-7-l!Ln.. ~-.,,.. ·Oil. aL;L~ Title, ~ ~ �11·· -26 D ,rfIE UJ.NI REI'OR T Form 12.1. ON PACIFIC COAL CO. - -- Mine No. / . ················-····--····· ·····•······ OF PERSONAL INJURY. 8up'ts No..................................... J/-~. ~ __ J. Name of Mine Su1Jt. C. (d,_,_ v-----v--~_ / Name of fvline Forman, JD--·f @ ~ ~ . . / , Age of Person injured, '3 d ?J c c ~ Married or Single ~/ ~ a h _ What family, if any, ti - --.... Haw long in employ, of Oo.' ~ £ ~ , Co 11dition of Life or Circumstances _ Name and address of nearest liuing Rel ~ ~ ~ ...,_;.~ ✓,, I:/---: Was he an efficient man, I if Where and in whose charge e t, Name of Physician called, if any, /4 c -.1.. ;3~ r . .--;:---7- • l . r .. ..A, ~.,., ~ ~. Was he temeerate, J e.-e-; ~"'":S:,H ~ - , ...,_...,_.._ r9" e , o6.... // /~ ,_,7 , Name and P. O. Adress of Witnesses. Nature and extent of Accident, U:2. / .:i-~ ~ <--<- ,:,~_,__ ( ' --=---✓ Cause, ,.,-c-~ (Signature) 7 Ii !1 ,.; Person injured, J Nameo; •. ~-~......--\. occupation, oate of Accident, ~ - - ~ , ; ; . . 3 ~ 19°'3' Time / 0 ,'.JC) Laaation, /d- a---~"'1' • -o/"y-c:, , Mine No. / Entry No. . riui·ed in Mine, state where, If 110t lrl.1 + l Title, ~ �STATEME.N'fS OF WI'l'.NESSES. �ffJE UN Form 123. ION PACIFIC COAL CO. - . Mine No. ••••••••••••••••••········ RT OF PERSONAL INJURY. JtEP O \ 8up'ts No ...................················•'----~L./", ~ 0,., Person injured, Name'I r::5(., ~ occ11pation, ~ ~ 790 -.......3 Time oate of Accident, ~ _,,,7 ,, d_ r · Location, f t - ~ . If not injured in f.fin,, state where, / t/2:.-1..<7 Mine No. ~ ~ Name of fifine Supt. ~ /$ . ~ ._--:;,/ Name of Mine Forman, ; ~-?. ,{'E:, r Age of Per_s011 _injured, ,. ..-,:_"'-.>/( ~ Married or Single • (jy 1..f t,;; ; /) A I/? ~.-?--<-'_ ~ V/hat Fam~ly, if any, //,..,.,/ £ = - ~ ,-,."'? ..e c . . ~;r -c..,r How long tn employ, of Oo., ~ond1t1011 of Life or Circumstances, Name and address of nearest liuing Relatiue, /.'.7"~~---.:r-, was he an efficient man, ,,....-1/1" . ..Was he temperate, ~__..,...- cr--.u~ a~ ~ - , ' ,;,; A/~,,: .· ~ ~ (~.✓ /\ , \ o(. Where and in whose charge left, /lame of Physician called, if any, ;w __~ /./ • o<: ..e._. __ ( ___ . / . - /; Name and P. 0. Adress of Witnesses. I·I I Nature and extent of Accident, ' 0ause, ✓~ --_,,___~'-~ .,,,£;_ ;;:n_f,~~;£-;~/ ~~ ~ L ~ ~ -,,,,_A..-<.-n./ C-7-1~-GU. ~--"-f">,,z..<.._ ~ ~,.,_/ ~ - ~-- -/?~ML ,7 ~ , - - , , £ ~ /L~ ~ , - ~ , _, , (Signature) Date -.>~ 1 ~ - ~(jJ~ Title, 7J1. cft. �STATEMENTS OF WITNESSES. �.......------~----b'orm 123. ONION PACIFIC COAL CO. ffJ6 ---RT OF PERS ONAL INJURY. -■ . J Mtne No. Rsro \ 28· --···············,---- 8up'ts No.............................. ~~ _,,.,_ !lame o,,; Person injured, -... - ~ • - ~ - -._, occupation, . ~ o(ltc of Ao°A1den ~-~ t.,,,(/ ,,:2. ~-d_ 190 ---....:,-':, Time / 0 ,..., , ~---/4_/ 9'✓ • -..:.,,~.--.n-~-.,../ Mine No / E t N 0 ~ ,,, / Locat1ot1, .-'7 • n ry o. ~ , Room No . . •ured in Mine, state where, If not 111} pam• of Mine Supt: ,},,-,"':,~ ~ N a m e of Mine Forman, J ,o/. c9" ~ ~~J {ii- ~~ Married or Single What Family, if n11y, CR--z.t-!i!__ How long in employ, of Co.' /~ Condition of Life or Circumstances, address of nearest liuing Relatiue, ~ • ~/ ~ Name alld -f ~ c:___~ was he an efficient man, ~ . . Was he temperate, Where and in whose charge_left, ~~(~ ~ ~1 ,. Name of Physician called, if any, ~, .fl+, Age of Parson :111111 ed, ;J/~.7 , Y, Name and P. o. Adress of Witnesses. Nature and extent of Accident, Cause, /2(/4_ _,,,__ _ , _ ~ ~c-~---/ fa)~..-.:: - ~ --< ~-«/~ ~L~ . (Signature) Date 1 Title, -, 1 �1111.....-~ - ~ ~ ~ ~ ~~ - - - - - <:- F onn 123. v~noN p ACIFIC COAL co. ffl•~ /?5pOR Mine No. T OF PERSONAL INJURY. 8up'ts No. ,.; Person injured, 11ameo, J_ 0 cupation, _,~ o:te of Accide~nt, ~ o ,/ 190-...3 Time . ~~ Mine _ No. Ent ry No. - Location, . I Room No. ,,--C-<A- ~ /_;- ~-~-. ·ured in Mme, sta e where, /jnottnJ (/ ~ ~ . v hf q , ~ ~ 1 ~~~ Name of Mi~Q.R,~~~ I ~ o ~ Nan,·c of !,fine Supt. . . d / c fl/ Person m1ure , / 0 Ag ;.; ' l'/hat Family, ,, any, ~ Hoiu tong in employ, of Oo.' ~. ~ Name and addr~ss of nearest ltut?l. Relat,~e, V/as he an efficient man, ·~ Where and in whose charge_ left, ~ Married or Single .. Oond1t1011 of Life or Circumstances, ~ ~ ~~ , ~~ Name of Physician called, if any, Name and P. o. Adress of Witnesses. Nature and extent of Accident, ., (Signature) Date C-?-t:;-<13•. oa. 7 Was he temperate, . )J • I I ' ---- _ ~-#,,,✓ i , , - ~ __,, ~..../__..,--7 . ( - �TIIB vNrO REPOR F orm l!!.1. N PACIFIC COAL CO. Mine No. ························•···•····· T OF PERSONAL INJURY. JW 8up'ts No..................................... /7) r/> ~ ,, ~~ J --4- Person injured, , ~ Name " 'y'J;f _, ~ J/1/ occupation, ,, ,., 0 r:: -- - oatc of Aocident, Location, ~:Z:..~ / ,r ,, 190.--:!, _cJ?Y~ r ~ t f - ~ ~ine No. If not injured 111 Mmti, state where, / / _, .3 o Time ~ Entry No. '7' J, >;.~~ No. ..rt, ,,R; --~ ~-~ Name of f,1ine ~u~t. ~ __ 1/, ~ -- ' \ Name of Mine Forman, ~ () ~ o" P erson m1ured, c ';I- ~::1---,..-·c--<::2- -- M • d . c:rT,· • e --~v'_ _ arne or Smgle ~/"J_L; Ag 'I What Family, if any, .. T -, ,., L1i+e a· c'J J' or trcumstances Ho w tong in employ, of Co., ~ ~~~ Oondit~·on Name and address of nearest living Relative, /7(-~ ~~ ' 0 was he an efficient man , -~ / , ~ ~ / . _,a ,,., vvas 11e temperate, Where and in whose charge left, ,::- ~ ~ , . " 7 " ~~~ ~o! Name of Physician called, if any, ,.6)_.'-". 0.> ,,. //-,~ ~ -71 • r:;,2,-"'- cf. Name and P. 0. Adress of Witnesses. Nature and extent of Accident, (_ _ (Signature) Date C-'1-15.03. . on. 7 Title, ~'~~...z:J �Form 123. TfIE UNTON PACIFIC COAL CO. Mine No. ........................ ········-·· REPORT OF Pb"RSONAE INJURY. 8up'ts No. ·······--·············· ••••••··· .. d /7"~ ~ Q . Name of Person m~u:J , ~ ~~--<Occupation, ,..L ·~~ ~ . . / • oate of Accident, ,2,t -7'./._,(.... ~ c - - v 790.....3 Location, ~..,./4/ ~ - - l , . A . . - - : ~Mine No. If not injured in n?in<', state here, Time ;z.~ Entry No. Room No. l Name of Wne Supt. ~ ~"?:: ~ A.. . Name of Mine Forman, ~ _ , ,, ~c.-f!.o~ 0 Age of Parson injured, l;/-h;:,;--JO c-<--~- Married or Single )-?L-c-_,,.~ ( • What Family, if any, ,,/r :_,,/_ I~ ) - 7 How long in employ, of Co., 0 ........,._,,, .e_../4_.....,_/~ °Jndition of Life or Circumstances, Name and address of nearest /iuing Relatiue, ~ ~__:.._ ,,, Was he an efficient man, ~✓. V Was~te, ~~( Where and in whose charge left, J:¥'.~a.-/? r -..:;:::-' Name of Physician called, if any, ,/Q..,.,.,., ~~ #, /4 ______ 0 ~-- . O~c(. Name and P. 0. Adress of Witnesses. Nature and extent of Accident, ' (. Cause, ~ 1/ -C--CG.-~. . / ~7.,_ .e-of _d__ _,._J _;/4__ ~ ~ ~ ~~ ~ ~ - ~ - -o r - - ~ ~ -c--u../ ~ ~ -.,..L--0 (Signature) Date C-7-16·00••011. b 1 ~ ................._._;z:, 7-" -c-L_~ r. ~. ~ ~ ~ Title,~ 1/ c3f~ �fl' Form 123. THE UNION PACIFIC COAL CO. Mine No. ........................ •••••••······ REPORT OF pJSRSONAL I NJUNY. Name of Person injured, . Oocupat 1011, Date of Accident, 8up'ts No.................................... ~- 4~ ~.?c,?,. ./..A-- . - ,),_.-v___.Y_,_...c,.- ~ ..2..7 '' Location, ~~~-r--Jj not injured 111 Mme, state wfiere, ..3 - (J 190 _3 Time Mine No. ~ Entry No. ~h ( 7'- s - Room No. SL--<- I~,:..-,~ Nnme of Mine Supt. ~ Name of Mine Forman, ~ ~ Age of Person injured, r-2-,,? % ~---Married or Single ~ What Family, ifony, ~ (:J/ _ How Jong in employ, of Co., ,:/- - - ~ Condition of Life or Circumstances, __ _ Name and address of nearest liuing Relatiue, ., Was he an efficient man, . Was he temperate, Where and in whose charge left, ~ -:.-~ - ,,.,_f' /k-..--.-R~ - _:.. , , _ .,, 1 ~ • Name of Physician called, if any, ,./{).,..,.., ?;:p, .,/::/-, v?:-"-c(, __, -- -~'-;-- $ / ~ ~ ~ ~~¼ ~ r· Name and P. O. Adress of Witnesses. Nature and extent of Accident, , Cause, ~ -4~✓ - - - J ~ r ~ ~ ~ ~ ____-L ~~~~ ~ e : f ~ ~ ,,..__,. ~ , _ . / 7 ~ ~ ~ ~ . c,,_~ ..-&..-7 ~ , (Signature) Date C-'i-lli•03--0ll, 1 Title, -=~ �STATEMENTS OF \VITNESSES. �Form 123. NION p ACIFIC COAL CO. rI-IE U _ -· ___ J?EPON Mine No. T OF PERSONAL INJURY. ·················•.......... ······--· 8up'ts No.......................... .~ person injured, _,,, ,, _-L._// Name O'I ~ C0_,,,___r rvoccupation, ~~ oata of Accid~ , / / ''. 190 -.3 Time / o ~ q, w Location, T',· ~0:-;?a.-..,__..,,~--2--~~Mme No. f ftt#-yy:No. ~~- R o ~ "( • ~ ,-y If 1101 ;,,jured ; 11 Mi11e, state here, - ~-7 /4_,/ flame of Mina Supt. Ago of Person injured, What Family, if any, How long in employ, of Co.• Condition of Life or Circumstances, Name and address of nearest liuing Relatiue, ~ ~~ was he an efficient man, ~ Was he temperate, L..--<~~'<-c:L,...c~~.-e:,.,C..c,__, Where and in whose charge left, Name of Physician called, if any, Cl ~ ~ ~~ J • Name and P. O. Adress of Witnesses. /7/--y Cause, -~~ ~,._ ~ ~--- ~ _d_ ~-C ,..,,,__,/~ ~ ~ ~ _,,£_:.,_ ___L__-{ / 4 _ _ ~-e ~ ~ J- ✓L__ ~ ~ I (Signature) Date C-'l-ll>-03--0ll. 1 �TfI"E O Form 123. NION PACIFIC COAL CO. 9Ef'OR T Mine No. • OF PERSONAL INJURY. ·············-----. 8up'ts No. ··················•·······-········ c:;z;,~ 4 .~ Person injured, Name O'1 y:1 _~ _ / o occupation, ~ / oate of Accident, ~ - ..:i- f' ~ 79().._J Time Location, ~ -,s;.'-:r)..,<...---z:;;>:....-..:i:_.--llline No. f If not injured ,n Mme, state whe B, Room No. .!t,.,,..,, · /. ~ Name of Mine Forman, Name of tti11e Supt (?~ _::;_-3 , Age of Person m1uied, ~f ~ Married or Single What family, if any, How long in employ, of (Jo.' fJondition of Life or Circumstances Name and address of nearest /iuing Relatiue, .7. ...-e'........:.o, , =~ Washeaneffic1entman, ~ . Was he t e m p e r ; ~ ~• Where and in whose charge left, W-~ ---./'~ Name of Physician called, if any, odJ--.-, =(, • /7 ~• ' ~ ---4, ·-;;e_ ~ c::7i2- J Name and P. O. Adress of Witnesses. Nature and extent of Accident, Cause, J, ~..2--~ f ~~ .,2 J _~ ,a.-c..-c..--~~ / --_,,._/ 3 e, ~L t . -d 1 ~ ~ --v--J -----~ ~_,.,.~,/ AZ e;,.?- .. h - f o 7 ~ ~ ~ __,_ ~ ,~ . ~ /....,,___,/ -/«.LL,...,.J r,,.._,_/ d ~ ~ __.._,, ~ ,{_.J.,_ ~ zL.. ~ ~ -?-cf -,--C ~ ~ - . . - / /.r 1~ ✓- ~ - i - ~ ~L -~---...,._____; ~ ;; ~~~, ~ C-7-15-03--011. ~+- ~ ~~~~ - / (Signature) Date ~~ 7 &-nr-~ Title, ,,h--;.~~ - , r-r'-f z: �Form 12::1. JON PACIF IC COAL CO. N TI-IE U -· J?BPOT? T Mine No. ... .... \ OF PERSON AL I NJURY. \ ~ .......... 8up'ts No......... ·············--· ••••••·· /1 ~ • c, ., Person injured, 11ame 0'I .£) / t- ._,, ·L.-.---"' 1 • occupation, "' ;J-- , •-~ t - - -· ,., AcciderJ1 Al L-c. c. -/ .• c.,.✓,< ~ -,,,_ / oate o, / J / // . Location, ' 1 • • ,.. · /;':,J • - .1 ; ; -If not injured in ntiw, state where, 7 ? L Nnme of Mine Supt. Age of Person injured, ·~,. ~ . <._. ,,, (/?,~a..-e---/{: Name of Mine Forman, g--.;,;•c ~ ' • ✓(✓ r-1' ' cr-v Married or Single _ _ -- ·-;/ ~: &'\,/?-------- What Family, if any, How long in employ, of Go., Name and address of nearest living Relative, 190 3 Time flline No. 7 • 0011dition of Life or Circumstances ---- Vias he an efficient man, Where and in whose charge left, ~---9/-~,,_, . ,. , -. ~~ • // Name of Physician callee/, if any, & ,,_, Name and P. O. Adress of Witnesses. ---- ,,,e,.,, ~/,..,,. r/, ... <' , ---- ••,, Nature and extent of Accident, \I I Gause, !""r.:l l . l_ ~, ---( ? -VI -Lr , 1:... ,.,(_.___cl ,, a..--l / .,,~ C ,/ r "<. , / ,, r ' -? - I': ,( 1 -~--r-r.,,,--C- ~ ~r-, i . --~c.. ~ ~--1-- L J -~~ L ~ : I l 7 d ~ ~_,£_~,,.,,,__,-, ~ (Signature) Date 1 Title, - ~ q, 0, " - - - ., �...r PACIFIC COAL CO. NJol ~ U rIIE -- - T OF PERSONAL INJURY. REpOR 8up'ts No................................... . !-c--?--c~ Entry No. ..J> Room No. .z ': {;1ine Supt. -~'ir .u • uY-L. .,,.AJ Name of Mine Forman, / n- c, , _ / r . ~ ~-----• d or Single ,4,_:_~ / Marne , Age of Person injured, ,l ~ ;?~"'-&~--,-~ What Family, if nny, How Jong in employ, of ao.' _.,, •-....-<-/~-------- Condition of Life or Oircumstances _ Name and addr~ss_of nearest liuing Relative, ~~ ~ ~ ,..,,,~ - _ < Was he an efficient man, ~ Was he temperate, ' ~77~ • -;y-°· Where and in whose charge. left, )Jjt:7 •'::',1,--~'_,_o/ '~ . ~ _,,./_ _&,_'>'~,-= -7P , ~~ _/ • Name of Physician called, if any, y . - :::::,v1 .--- ,_ ,__,.._ _,/ . • • • -1 1 /lllflJe 0 I ' ¾ Name and P. O. Adress of Witnesses. Nature and extent of Accident, / t!' ~ _,,-1,7'-p....~/( .-I f l 1. (Signature) Date 7 Title, 7Jf. if. �STATEMENTS OF \VITNESSES. ~-vi ---b/e /4 _/.~ ----- •... ,, ~ r ~ -~~ ~-y.._ ,, ~ ' - - - ---Z- . ~ - v ~ # r ~ - ~ -~~ L _ ~-I' 4uz- ~ L~_ _/4 --e1r,_.✓~~ /4.- _,,_-~✓,, ~ --c>• ,--c/ J _.r/L ~<-- L ~-- .c--C./4-✓ /4 ✓L ~ ~ ~ ---c/ -4-v---/~ ~ ~~ ~~ t:J6-~ ~ ----( -c:,_.,~ '(1/L d ~ _ __zL____...r L - . / -4- ~ ~ -~,----f ~ ~, --~ /.-z./ ~ u~71 ~ -er---r ~ -L: ✓ ./4~~4 ~ ~ .l L . . . =( - ,.~~;yi.-e.--;e,_L_ ,,;, 7 _._.,.,--~ - t--={ =,,p ~ - - ✓ -·· ~ 4,,..,, ,_/-/._.__ -:~ --~~ /-,..._,~ ~ -------- /v<-_../--._. ✓ ~ __ . r- - ~ ,,..L~ ~~---11, / < �, 'J'Il~ uNTO.N PACIFIC COAL CO. --- Mine No. .......................···- ••·•····· REJ'ORT OF PERSONAL INJURY. 8up'ts No......... ........................... N•'"' of Parson i11ju':d, :? ~ ; I . . .,["_)_,,___,, -~..,_____.-----occupatio11, // f-.:•a_::, r ,,,__ /?f'--~.:.<--,,,,,__,.:_,.._ (Jato of Acc:ziden, c;;r·r .___,L-.. -n _, , ccc. .-,.--c..,.~ 190 3/- Time / f ,7" ,, / / (1 ·- ~ ....__...~ q. hf. tdion, v..c..··.,....,~ .,,t,..✓• =- > Mine No. / Entry No. Room No. Loc If not injured in Min e, state wh! rc, • ✓/,fr, , ..-L,~ ~ ? _ - - - Name of Mine Supt. ~~ Name of Mine Forman Age of Person injured, ,.,,2-.£_...-__,~Marne • d, or Smgle • _,, . , r ~ What family, if any, v "?-r--<-Co 17dition of Life or Circumstances HoW long in employ, of Co., :;.. ;/7,,.- ~ • /. '1,/ r ~A) • £? Name and address of nearest liuing Relatiue, ~ r""G~ c..- , - , ~t'- , ~ _# 1 Was he temperate, ~_:;;-- • was he an efficient man, o/_/-11:,J __ / Where and in whose charge left, ~r-~ , Name of Physician called, if any, o62-v. cY, ., fJ_ ,<:Ai)'./_ ~ // - - -:;::J' , c:fl-~. q, . . . 1 /, ' . . . .... t , . . ~ - - t ~ -i Name and P. 0. Adress of Witnesses• .. Nature and extent of Aaci~ cr~ ,-./ ~~(7-:"'~ --/ (_ - r _, ,-0_ .,, ' / / r-£ ..-, - -- ,- c( cl _/ ~ ~ ✓ ~ LA~ ✓ .-dC..-~-J ~ d_ ~ (Signature) 1 Title, I �STATEMENTS OF WITNESSES. :I·, I . 4" I ' • /n1 , .. j .,.._£,,__,.__. Ci./2/?_..:-,,_, c._,_d _ e-,...~ , C' , ' ) , l.":-'1, I $-.,,,,..,. L'..--,. -<-c_ f I, I I l-- ( _..-_/ , ~ y \ . _ /) -----. , (~__.,,,- a ~ �1:1:S uNrON PACIFIC COAL co. 'f J<SPORT { ---OF PERSONAL INJURY. Mine No. • ••••••••••••••••••••··•····· 8up'ts No. Jrr£r-_/ ~ - ifurad, ~ Person inL Name 0" , ~ . ,t_-p-~ occupat1011, 0 note of Accid<;j/· ~ 190 7'- Time ;? d ,_. ~~ Cf, /.7(, Location, / c~o ,, x -d' • • Mme No. ,;:z Entry rlo. - \R N - ;ured in Mine, state where, r?--,{ ./.Q . / I ~-~ _ ,, I ) oom o. /Jno t l 11'J r_...,. <..-c.; _.,,...~-c..-r..,_ ( -1"d l - , - ~ Nam• of /.tine Supt. , /~' .;: , , ~ZL-<c...?La-.>< Name of Mim? Forman, A ? Age of Person in1ured, _.,_ ~ - = - L - = > - Harried or Single ~~ What family, if any, C9-_,,.,_e__ cf7How long in employ, of Co.' ~ / .1r- -,►,.~ Condition of Life or Circumstances, ____ Name and address of nearest /iuing Re/atiue, ~ . was he an efficient man, ~ Was he temperate, ~~ Where and in whose charge left, ~.....-...<. ~ .,,,,- c - . z - ~ - -' Name of Physician called, if any, ,,d)...,___,, ~ c-= . > .... ~ - I". -..-.__, = -c, • ~ _:J:t!_ . ~~ ? ~-.~ -r ~,/' Name and P. O. Adress of Witnesses. . H 'Y"L.. ~ <- Jr, rec.~~ -z.;- ~ - L - = -f?-f ,f~ r r- ,/?_._,._ ,,. -:• . __ _ .LL;,/2.L-,; t...-c- t" I _.2 J ~ ~ --,. t:X.Le--~ Nature and extent of Acoid~ ~ f ~ ~_..,_.. -=..z::::- ' (Signature) 1 *- or <?~~ Title, (SL~r C7 ~ - ? :;,,._ 7Jf✓;,~ /l o. ;I_. ~.-,(./4 I �~ - - - ---..-.-- ~ ~ ~ JG UNION PACIFIC COAL co. 'ff --- -J?fipOR li'orm 123 • Mine No. T OF PERSONAL INJ URY. 8up'ts No............................:....... Name o,f Q~: _,_L__~J-( ~ Person injured, • ---Q.._-- ocaupntion, ) , r ~,fAccident, ~ ~z::.. ~ ~.../190 I OtltC O'J _/ 2 - /,) /9 . Location, P ~<-j Mine No. . ·uredlin Mtm', state whet e, If not 111/ ;7/~ --r I ~- Z.,.Ce_,y- CZJ. ,,___,;_.o/--C<-/ /__ Age of Person ~11jurad, ,....l~ / 7.,G.- ~ - - - ~ Name 01 Time / (/ f,finc Supt. ( • 0 o ' ~ -<.. Entry No. -......-3 Room No . Name of Mine Forman • , Married or Single __,,.,.-/ . -#z C/-:~~-- ~ // -c---L._e-~ 7 Condition of Life or Circumstances, :¥-~ ~r--h-- _ ( ck ~ -J What Family, if any, H0<U long in employ, of Co.• ~~ Name and address of nearest living R!fptiue, was he an ~fficient man, ;fe--?..~ Where and 111 whose charge left, Name of Physician called, if any, Was he temperate, /N.'.""G-;---=· - /-~~£-...___ ~ ,__d- .,.,_ ~Z ,,. .- ~ ~ ~~-e , Name and p, o. Adress of Witnesses. Nature and extent of Accident, (Signature) Date 7 . L? ~ ~ t7 ~ - _d~ , ~~ . o/· �STATEMENTS OF WITNESSES. ~-,d~-:..,, --~.,_/ J.~-~ ,,F' - ~ _ _ .,._.,_/ - w -=--/ ~ -- 4~ ~ _-c ~ ~~ t: ~ /r-,, ~ ~ ~ ~ £..~ ' 2'~ ~ ~ ~ ~ ~~ ~~ ~ 7 ,L_;..,__.~~ ~ ~ d.:- ~ - ~~ .:J!--Rf~r-- ~~~ ~ ~ A --~( ~~ /<JCJ~ Jz-~ ~ ~ 7 ~ /ZL- - ~ _J ~~ L-fV-.-~ I ?YL--y (J6-~~z;:;~ - ~~ /h uL.e _ ,,~)p --:7----r_,/ /d__ ~;_~y ~.z::L_ /'3 "", 4/ ~ ~ --- , - ~ �J; v.NrON PACIFIC COAL rtI ~ l•'urm 1!!3. co. -~ - - flttf'O'R AO Mine No. r OF pJSR.SONAL INJURY. 8up'ts No.................................. ,1 Person inj11red, //(1/118 O; ._ , .£_e__:, , r- fi~ -.. occupntion, ~ ,, e:,2...; " r - 6 natl'- of Accident, t:7 ~ / v 790 1/ Time {p ~~ ~ Mine No. ,;i... Entry No. /~ Location, ~rn., . ~ I . titired in t,1111e, state whe1 e, If not 111; G? ~ , 1 , Room No. 11amc 01 Mine Supt. , /, 9. 7 >-,,,, c. ~, I I ./ / j_, O:!/ Age o;,; Person injure(/; What Family, if any, How long in employ, of Oo., • -1 -~;,,-;,, -t?--?-, ~ --Condition of Life or Circun!!Jang;s, _ _ _ Name and address of nearest liuing Relatiue, /t-"'_.....,~~~ _ ~ -a..~ Was he an efficient man, ~...:fc-,;:;,~ Was he temperate, ~c?____/ Where and in whose charge left, l (~-~ -~--<,.A - - - . i - P - ~~ Name of Physician called, if any, c-/()_-1.,,,,, _....,.-,( / r /',? ' 7 _, , ,--1 Name and p, , o. Adress of Witnesses. ( ,, ~ aause, ~ 7 ~~c( Jy - ~ --L;,_, ~~- ~ ~ ~ /~ ~ o.__/ ~ L-- ,,,,£~ ~ d__ <l--- ~ Y7' . #, ~~/~ (Signature) Date 7 I l I �'f -1,1T OF PERSONAL INJURY. Mine No. ~1wo \ 8up'ts No.................................... ~ c..7_ , ; ~ -,~ ~ ,r'j!---t.-~ oac11Pat1on, t - / 790 ,...3 Time Accident, ~ rL-L/ ~ J/J/I oato o1 (1) /4 , Mine No. ~ Entry No. Loc(ltion, .:,--r-- e. . ,;,,red in Mine, state where, 11ame o1. A.1 ! T ••••••••••••••••••••••••••••• ••••·· Form 1!!3. flS o~roN PACIFIC COAL co. ;J1--- person injured, J <) · ~ '--1 ~ _:i._ Cl, >r(. Room No. ~F f/nO t 111., j~ • X: ~~ Name of Mine Forman, ~Y, ~ - c . - ~ -Name of Mine Supt. Married or Sinale ~ Age of Person injurer/, .?- .?- r ~ What Family, if any, -How Jong in employ, of Co., ,_J--,.,..............-...~~....-Q..--- Condition of Life or Circumstances, /lame and address of nearest liuing Relative, _L .,,, was.he an efficient man, 1-:,----<Z--Was he temperate, Where and in whose charge left, ~ -....._.__~-·-,, ~~ Name of Physician called, if any, o<'.0..-v. Cj? / / i f...--.:f, ~ J~~ ~~ ~ ~~ Name and P. O. Adress of Witnesses. Nature and extent of Accident, ~· Cause, ~ · 14.- 4 ,.__J ~ L ~ ~ ,;~L~~ (Signature) Date C-7-tr,-oo--GII. 1 g~. Title, ~ cft~ ~ , �STATEL'lEN'fS 01" WITNESSES. I· l �THE UN J. RHPORT Form 123. ION PACIFIC. COAL CO. Mine No. OF PENSONAL INJURY. 8up'ts No. .......... ···················· Name of Person injured, » . ) ) ( '" T >rf{-~ l,a.-C...a-a-k (....,,/ ., oecupation, Date of Accident,, (7, .a.- r-,._o/ ./ 7'-Location, ~~a-:~"/ f/ a.-e.-e.--r I . If not injured ((, Mm,', stat., whe1 e, ~ - A:- 9 ' d ' ~ - '7•?:?/'. ~ Time Entry No. 1'" Room No. ~-sMine No. / 190 ~ Name of Mine ~u~t. ~ ~ m e of Mine Form~n, Age of Person m1ured, J ..3 .Marned or Single 1 What Family, if any, yj.~ ~ ~ How long in employ, of Co., .. ~~ Condition of Life or Circumstances, _ Name and address of nearest lwmg ffelatiue, Mf--=--'~-£_.,..<._ ,J::71...-,:::1.✓-,,:,,c-~, c-~ __/ was he an efficient man, ~.....,p,/ Was he}.w!1perate, ;,~' Where and in whose charge left, ~ - t : 7 / , ~:1~ fc-..eft'v '-"~~ ~ Name of Physician called, if any, £. ~ • ' r-~_ ~el' O o&.v, Name and P. O. Adress of Witnesses. Nature and extent of Aaoident, ~~~ + ~L-___,_.,_ C C( ) L ( l l (Signature) Date 1 ~ . �STATEMENTS OF ,VITNESSES. �Form 123. N P ACIFIC COAL CO. THE u~rol Mine No. ••••••••••••••••••••• ••·······•••····. , OF pBRS0N AL I NJUR Y . 9HPOR 1 8up'ts No. ••••••••••••••••••········ V~ ,.t Person injured, ---~ Name 01. OcCLI/JattOII, -zo~~~---/(...,<..-'7 ..t A ,·d~n oritr. ~1 co .~r/ ,,,~ / ~ - - , ;~,-e..... LocattOII, . tiurcd in Mi111•, state where, If 110t 111., ,,, 6 ~ u--~ _ 190 3/" Mine No. Tin1e ,Y O(,~, Entry No. /~..£).~- Room No. /2--;-3,o ~ Name of Mi11e Forman, Name of Mine Supt. g_..e.-p • / Age of Person injured, . / .f ~ Married or Single What Family, if ally, How long in employ, of Oo., Oondition of Life or Circumstances, Name and addr~ss of nearest living R(Ztiue, c- ;{'-<'-<- - - ~ t/ ~~. Was he an efficient man• Was he temperate, Where and in whose charge_ left, ,... 7 ~ A } j_ _p . ,,_ ,, .,..,__,,_;> L- f ~ q 0 Name of Physician oalled, if any, r&,,t,,,, ~ , • • - Z7- ~I r~~ r. . Q p ~ ~ '?J' Name and P. O. Adress of Witnesses. Nature and extent of Accident, c;7 _.,_I', C3-.-4,, /~- r.J-cf ,:::,,.. ~ ~ r ' Cause, I I- (Signature) Date 1 C-7-m.03.,011. ~ �• _i . I, u:il ./ ,. .,. .l (': 1• • l .~ :i ~, : :n ·~· Cu ~L " ..'1 ( .. (,..,','"{ ~ : - - \ I • . l Il I , - v:.:·~r•... - • ,l • ,... • I I • . 1i •. • :• . 0 .. • ,J '.! "· ' j"? • ~',.v .i· : . _, • U'n1""".; r 1 :0\1 .:: ,, ,, ,.ii, n • •••.. :; 11- d .. . I i.-1:: . . i• . • • ,.;('/'.• c·.i.~ ·,•- (; CJ. L .' ..... i"• in ,.. <.! L til t :i· ,,h... - , .. _. . ll • ~ • i1,:n c t,;l ;., li 1"1.J 1'L•.r: c ! .c·:, .. r ; I ;-i.mn · , £.'t • (.'. :·,. 1: ? ~ i' • • • , • 'f!i,.- T]_ . 1. l•.. •. Y.-u , 1.. - .1• ~ i !'t".l~<..·:n -:; in .·.,r c:1 ~,1-<: 1.lt.tt ? :1 l~ t l ,ft. r,f t :•,. u2· ,.. ' . .Jl , .. • !":i., }1', ti !1,) •.• V•~ l.'n: ~ ,:< n •.~; t .1. l o. • • ~n l r: . ri..1 ' •.,_ , .,. ~ ' -4 I • • 0 .. ( l.y .. ~ .. """ ,.\~l I ti t '" ;., U I ~ • t•. I l'i 0 '-~ . ,,!1 ,~ •• , t •...n ·r1 • 1 10 J.,71 1'! t ·l r.c, vvJ.; ' .... ,, .•:c. ·.;n c. j 1..11 l.l ,v I t!1c lj[:h1.. l 1, 1. i r- :li.1. I) J '. ,· v.- ; u,. ;,tis; J " :. t · .. t,; • • • .:. , r1c • C ' ,• l . l , ncl l1 ir.. c l.?:.'! , C Lh, ~r .• �• • y, •• • . () f' . , .l. t,, i~. 1::. • 0 • 1 • c, e i . •r . ,,:.. (: . ~ : i e;]: t·.ty ~ it 1~ f·q ....'~ t.l· J ' ~:[: ! t~ " ..,..,,' ..' ~.,~ ·i ,. ·~· ! " l1l,J o l ! r , 1,:10 '.i.':1·..i c c.-unv . ~ . t ,_ :,(l:~ . _... ,' ~· ~' L L~ ~,. , .,... , . . :_:o lnc ...1·,.. ; I l vi-~ .. I .i '.J " rJ ,.rem ,_;• • • : . ~ ;i.L . ''.l\ l.:nc' ; .:.: O!"u I '.' m ; v ...,1· ~ dro~. •;c,;, .}''1 r .. . ' t .. ·1:v ··::.:•. t J (., .0;1,, : ,(1 l !o i,'i·. L 1;, . t:11 I .:.'t.. ,. I / -'.:· •. ' :·;11 ·-1 �.. • f• ' ~.() i"C O u·Lu ( ~ i:I, C "• J . . 1:,·: li,) ... # n. ~ri.J:· ~:,i· ' • ...11 ' (' .! 1· c., 1 .... ..... • ·i~,~, • • . ..·:· . . ,, • -. • • • t • J ; .. • l • . • . I ,t ..n . l f I ' ! 0 ' \, t ?l( . •. s,.,. . , •:-,, 4,,. ., • ·,, 1· i. !'J C luV, 1' 1 ,· 0 . it! r , ·" .!: l1i ' .it ' • f }: I • • • • • • 0 '" i i • ' .. t.v ..! ! 1Jj r.r: ;: :i 1 r• 1, ~ l .11 0 t 1<!: n ; .: .'t :h,.!·~ ! , , . • ~ 1 : ... . i l L ... 1 i.n: t .. 1. (; . • • ,I_ ., i, • .}·· D • . .l., .C .: .. i ~ I • .• • nc., .. t ,• .! : , A,, lr n ,. ~~1,:: .C !'lv'i. [.'l 0 • :..n .. L./ ; c-r I • .. • n... ... ,. ,, tl '.,·; 1\.• ( ,, ' .,0 . • ;· to ... ... •j • • ·ll ., \ !·· \.. ··;.,.• ' .. :~ ;? I ., • .... \,1 ·h.:'. t,J ,- !ll d, . ~- ....,,~... • 0 :: l"11/ • .:y --n .. :, ' ?l •~, ~••: -4# . • , :_ t·1\) 1./ :;. i \ l :<- r, 1~:i. 'il..,t-.? ~.\) ..·••. .. .: .., .. s"'I:. n i. ·!f -:.\! ' :.u t':1 . •. .. ~ !1 ., -: ' .,. ·-.. •., ; ..: !1'-..? • • • 11,•, t , t, .,1 l"li: i :,1 . ... , c.r y: • • 'J'•' .,\. . ' ,,..,, . ') .. ' ' & (,~ - �0 ~ .. , i . 0 .:. " . .. , .. ,.:.n1 1~ (, •"'v -.. tl. ... ~- r: co tl1. ul t~t :a.: ,. .\.Ill \ f ,, '· .,. . '" ... I ·- t ,,; :· .,tj !1 ...... \,~I . ( i'l.l l. 1 ,, : , r ·- (./.1., ~ t , t. '-' !. • ' .i.111 - 1:: ,. I.', • J. ~·-- ~ ~ ~ ., .... ( ,. :.. C ) t, .·., o.-: I: • C r>, . ( ., ·' "'P . Yl ,..., '( , 7':ti .1 . <..i.' ,~.O ' l · , L!. 1,·-'" 1 ,. '!"V· ' l. r; L: ' C, 0 ·(.;i., 1~ • ' I ., '· t'. l l , I, c; .. ' !. i r v:L ,(j .. 1 ;t •J . l,, I_.~ t • .l ( t v# C , '\.., ..I • ,.., ' n c. . r' l' :·tJ. t •...n n f -_,., ~ . - ..,~ : .!. " (J �Form 123. ~ v~roN PACIFIC COAL co. fJlP pJSPOR . T OF PERSONAL INJURY. 8up'ts No.......... ··---------------· /• ~ r --•J -, Name O;,-F Person injured, occupation, oate of Ac • Location, If not injured in Mine, state ' / ?' ""790 "r Time • ( Mine No. 1 ~ , q / ?--r::>~ £ t C>' r ," ,:r--cJ N n ry o. J v -~ / L,, :Z: ~ Cl,_...__# __ - _L--, -- ~ Room No. ,t:> • _ ~( J.-:z.,.,- -7 , 1 -- Name of Mine Forman, ~ , Name of t,fine Supt. e of Person injured, ~ Married or Single Ag What Family, if any, How long in employ, of Oo.' ,:i. Y 2 - ~ Condition of Life or Circumstances, --Name and address of nearest living Relative, ~~ - . : z . - - Was he an efficient man, ~ C Was he te,erate, ~ ~ ---; Where and in whose charge left, r-x..-r Name of Physician called, if any, - . I Name and P. O. Adress of Witnesses. - ~?--/L--e' , Nature and extent of Accident, ~~( i J (Signature) Date C-1-15.03..00 . 7 r, Title, ~ ~ Cfr ~ �STATEl\1EN'fS I I OF WITNESSES. t ••! ' 'I I i ; I 11 nr; ,,1 \ t.ytP ,1fta ffOI~ • ,·an 1as __ J i1he ra11 O OP Yo 11ar Cmrbc-rl&nd , t'yo o Jan . 18 , 19G,, I ! //at i n No o 1 t'ine on In making my exP.rr. 1 rm ti on as Ga.s P;" , ""'tc'hr.en , .i the morning of tbe 10th of January, I round 100 cubi c feet of ~as in !·!o. l Room on the Sixth r1orth. \':'hen ca lled for b y P~ntonio Car agr o.nda , , I told him that his place ·was not nll ri ght ; t hat there we s ga.s in hi: room o,nd tha t I wanted him to 1r.oep out and h0 so i d a l l rig ht. . I said "do you understanc1ncmd he said yc so I al so had" G~-s0 tn·i tte n on a boerd, 11 ltcep outr: Oa VJhil o eating my breakf ast Forc?ran Faddics sent ror rr:e fron the Fifth l evels. He ae.id so~ebody had 1:1 ~i. ga.s on the Sixth. 1 11 ent 1 down at once and found it was the wan i n No. 1 .r\OO!'r.o ~ ( s i gned) • ,' G. F. l1.ilde ~ Gas \7atchl7!e.n. �Tf16 (J Fonn 123, NION PACIFIC COAL CO. J?EPON T Mine No. ••••••••••••······· OF PERSONAL INJURY. 8up't8 N0 . ............................... ,.f Person injured, ., _ Name O'J occupation, Date of Accident, Location, ~~ ~ If not injured in Mine, state where, Name of 1,liae Supt. 0 ,.,_,,,,., Age of Person injureR' ,.,?. ., 1.f • 190 f- Mine No. Time / 7/3() <f, hf, Entry No. 6'. ,d,.-lf, ~ Name of Aline Forman, J Room No. ~ ):;,(, <:ft Married or Single ,,d,,.' ✓r; , ~---- ~ (/ / --€'.. -r What Fam1 y, l1 any, How Jong in employ, of Go. , • .....- ,e__./.-o_ ......,__/ Condition of Life or Circumstances, Name and address of nearest liuing Relatiue, t:/, 4~_,J1-~_,,-dA.:__, ( ~ .,~ ~, / ,,--~:l'-a-,--c-~ Was he an efficient man, , Was he temperate, q~ ' Where and in whose charge left, ~ - o . __..g,~ ,..,,_ - ~ a ---n ~ / Name of Physician called, if any, /Q_.v. 'Jr ...~ , , ,/. / . .-/4- '7'~-c1---- Name and p, o. Adress of Witnesses. Nature and extent of Accident, Gause, (Signature) Date 1 • Title, �Q,u,.,c; t ioncd by ! 1.i=c:·e1 1. _ ___ _ _ _ Q. '\"'no th... r ock u.11 i n a oo l id c··unk'? t . Yoe c i r . ThGre mi ~ht h;.,v e been u, f cu 11 ~.t l (, ,1;,i0cb:: hrok ~n off . ~ . Do you. t1:ink t h~ p r ov wo.e kno eke d vv. t b . • t '· u sJ, ot? /I . I t hink -:.110 p r op ,ms u i ther kno ck0d out h-· t 1, ~ e;;• ct or Lh.o r ock bti.inc a o J,1;;,,vy on one ai <le t 1~r.t i t kno cked t~'?.C ..., ro11 out . ~.u , st ivncd b;,r L ..;vson . Q. You u.i d not t :-y to r;et any cotl from u.n , ·~rn\;o.th t c -:..)t t.11.;: 1.,'.n oi:t . f\ • 110 si r ~ . Don' t . '<. u t}: i nk t ht.. t ·.;ou td ha vo 1J L! n a ho ·::t -.:r \'lt.y to w e; c,, -:l;n tho co1..l f r cm ·, •nc;1.;r hin? A. I uon ' ·.. ;_·• .' nk "s.O c ,.. t!ld }iG.V"' dcnc it . Tfc d i c.. not mov ~ ,:h en \le l ocked Ltn c!.:3 ·~ . r '-- ~,ot c.. i;rop u.n6. t r i~d ~o .1,n·· t tho rock a little bu G .. e c uld not c;J'G l· im out t:u.. t ·.:o.y i 1 hc.1.Etoc 1-:ou -.. v . l t1~i ud .,o _mll rli' , cut •..' U!1 th.vy \, ei·c 1ii clc n :~ i "i: . t1 . .., . . .·' ,..., t. . i • ,, - - ,, • J- .. - - t / J • • - · _J._ I �J ohn t ((, -:j .· ,, 1· • • :imc t:1 :1::; •• an ,mo h v.r t? . ,, . • l 1ha t C t..U C ~d 1 1, t o , 1 r o_p u n d0 r it f i r vd b -. fore knoc it . ? Q. wa u the !Jr op l y ing vnck: r thl , r o ck A. P ~.ct of i ., . 1',• J,•Qt ono 1: r ep ? • Thut \, t.e u.l 1 I LJv,vt unde .c th, r ,J c!: • Q,. HoH h i e u u.a t h c.t rock? /• • I f.i1~• t il d .j u<.i.r·e i t ..t.fl c.1.:iout :-,ooo o. c cul d you :::00 11li>ce t ~t c • put i n v~u h r t oho t ? . Y.. ·~ , r· : v .\ 7 it h u t r nev.; r \. oak o.n~r . t...rt icul r not ic l. • n . !-1'0 ., :;:. 1· f r c m th-.; r o of vtas i t ? .t I co, ld not ::a.zc...r 110 :: i'.:.r f ro!'I tJ~.: r o o f • . • Yeti c,·,1 ~,. i z n 0~ ~~ i n t h of' r 1:c l ~? . ,• Y .... c :.: i r . '· • i)id i t c}1 i p off o.ny C(1 Ck t',t t 11v-t --nd t ht.t \/Or ld b e n d t h e n..; ,~ dl8 or 11ou ij ;i ,~ c o ... 1 do t ,...~ t . A.o I l ooked ••o ,:1.;i o.c • h c., ucht t '1.o 1·o ck ::.·.ll l ing c i <:. t , ....t . If the coal hud (lc,ne it it ,/r, u ld hav ~ b~lm 1)&nt dO\'ln <~. Hou h i t;h i s the f a.co of th , co 1 /' • I cu ea s it i s 4·} or 5 ' Q,. Di d you s e ,9 uny r.or~ .,>ro j_> S in t he r oo f? -~ . Ye s •. ir t 'li .Jr e ~r e 11ru} s i • t h e r oor., . I n ot ic ed r 4 o.r ounl t 1 ;-.; ·re r~ . Ho.: -f.'t 1· f r om the f o.c e di d t h EJy h::wc th,.:ir t r v.ck? .:•.• I c o.tld. no.,_, s a e (,• .Pny 1Jody els <.: !,r c1:;0nt in t hu room? , 1 . • .I :i?t.rtr...,r , ;- r . Ross . Th r dc: of us y,ent in f i r st -Le try t o 10f t the r ock t :n cl. I ,:·..:"1t do1,,n on t h6 t..ntry i.:.nd cot the drive r . <~.J. Di no t ic e ho\, f .... r f r om t :ie t op tho.t h o l e was , ut in? 1 :.:oc.E ~'i i.Ll.1. ... "-• Ho••• i'a.i.- f r o::i. th.., t o:.:> ...:r (.. they su1,p os e d t o 11 ut i n the h o l o? A. Ov.., r t ' 1.:1~~ .,1Jou t G11 from t h e Lop . o.. l~o 1 <..:J:: tJ1t..n t h t t ? 1 A. \ 0 li.t r 4ly e v c.:r :·ut them clos er to the ro of th.,•n tho.t . I f we do i t i' a !'li s t a.ko . (.. ".'cu l o. t h:.t k~op t h e ro of s e a. i d? 1' • Y'c >..ave hacl no t r cub l e so f o..r . Q.. no :,cu t h i nk r.h.. t ·.,ould loosen t he r oof to huve ' hi:: s h o t up that c l c: sc, . A. I c 01• l cJ. n ot, t ell . I t h i nk i t .:ouid h a vu o ome e,ff u c t . n_. Ab1 ov.t \7ho.t .i mEi of d u.y '.10.s i t ? J· . / )c•u t t , ro o 1 c l oc1': . 1 ~• ···,. G t he •••Ci f~ht of tha t r o ck on h.im dire c tly or pur t l y on t-1-i. e c o i.J.l? t • 'Pv~r t l :; on "J1~ cot 1 . • mi.a.t lJt..r t of t11 ~ r e ek ,,,ac on !:i m? Th..: .},) ...rt t lu.. t v1c;.s clos e t o t ho f a c e v,o.r: on r, im. That ,·,us n o t t 0uchinc G.nythin g but h im. �r . .,.o ~i: .i.o ' UJ1 ::, Gill i n t~ r,; 1 r~o . ,~ ~s~ioned hy Luuson. 0, . !>id y1,u cc.ution L~_,; ••1-.:n u.1::w;;.t s~t-~ inc t >i_.:: ..~r u1, on .... rock? /•.• liro ths:;1·.) '."/OCJ no .1lCOlJC :..1;..t on ,,:·e, ck ,.:h..:: ~ I i.:ent o .~_ft.:; r cx.....L1inin~ th0 room I found the timl)o r s c on t~ roe ·~ . I 1. i::; not :_,c,ct ic od 0y 2:c..,:~ri~nc .:d mi 11-rr- . • T~ ..1:1 c1ist£1.nce a man put t~2 ho l e in to -ch;.. coc.l vcrics ..:.cco.cding to t:1,) ccintli t:i rm the r·oof ic in, '1• ~!',...:J,l, io no :·.,L;cial c!bt ...ncl:l stipul~t e d not t o wu.ke his hol~ in tri~ 1 1 1 .. • r (,Of • j,.'4 17ot my ~-~o ra t:.1: .n ho 5.6 inotruct ed not to inu.ke :1is hole in the roof • 1 :Jut c.. 10 1 0 si'o ld '>emt~c'!.e over t~- rnining--lD'vur 'i;h o..t ,.J ort::i.on of t~11.. cot,l t"Lt i:. u.nc1•.t'!.1in.,:! . I f a 11ortion of the ho l e g3ts ov .. c ~!. _t ...;:.. rt of 'th. co .. l -.~,,·t i ~. not ·mc...:fTlined thJn i t mukes 1-- •·uoh htrtl•:r for ·i;h\:: !JO\ld(:;l' tc do its ·work and in the ~O\ld.:, r .::x1,.:-.nding it fir8f. it lco~ e b1:: c ;,.m,.. e th~ bot ton unciv rn..:;; th it ht::; no-r h•~-:n -.,o rkvd any ~,,,.y for i t to breuk dovm . Thnt is tl1.C:J C L.'(}"(; of ~h;;. }"O lt1 b.~.a .Jdnc t h3 r c,cf. <" . Ho., f.:.r f rom th.t: fo.cG of tlto room Yr~ c;; the conl thro\/n frc.,m the lost at!.o ~-? ✓ • C'_ . I · I ·,10 ld judce it ,,ou.ld be _probably 1 ~ ' from t he fe.ce of th'3 oho t The or.ot ,1a5 0{· ' from the :.:nd~n.1 ining t hc~t \'JD,.s rilo,m off. T'-le .:., o.; t thc:..t v:...s displao~d, I don 1 t think \"/Ou ld be mo ro t han 1/3 t1•Ltlt clistt>.nc c A r.u.:..n c;.n u 1\1a·,r: rr..:it a. ~>rop by ordorinc- it? ~.r '-" ._ ,._, •· koup r.. SU!Jply of 1,imhor in a.11 the t:;ntri cs of diff1Jrcnt l ,.n ·the th,.t o.r o to be uoGd in tha.t entry to ,.o t h...?r \11th 1.\. Ult'Il1)-.r ~:::- C~l>B <.: 1ui v~~lont !.<, one cup for eu.ch pos;, . i.:,Tll.1:y ~re di stri but t;d \ • • .1...,0, I tln •:,.•on t'· c:r ...ru ord<..ro d from t ho m\J n v1ho lu..ulinG their , \ . • H~ hc.d ~xtrc:i '.!.J_ro_ps in hiB room? . . A. Yue , I 1 cund t ' 1..t thuro Y1ort.:i four ,PrO!JC t.nd oix c ups t · a.t had not ~ t • to t ':.\.: c u.rE tr;; �" i: "th d.c ,:, OS CZ .1,nd CI 1 • ,.. ..i,.. (,. ,_,.1.,i~.:- ':/'· t', i .. Yt;S Gi:."'• <: . S "tL#~"L"-: "'vt 0, . Th(;y ::.ire:d out to you o.s oxp eri c no ed I!', in ,:: n 1? I , oked thee: ·;:!,.en t~:.ey cor.r.:•11.m ced to v1ork i f t h ey had ever minud co~.l 1)..::f'o:ta ~n d they sr.id yue . Ana. t r:ey hu.e mi ned co a l b.Jf ore. i ~r~11 t~\) a.ept~ t~rt thwy had 1Jeen mar ing the ir mi~ing. I wo·;_ld JU~ce. i;n dy. !1::...a. mine d co.:l bu f ore us they ,;1er0 c.bl(:) to lie down .:.nd :"', J.ne ~ which dorri.onstru.tes a me.n hue had somt: ex )L:ri ~mca i !linin~. ft • How ~ltllll'll f.,,r f rom the ro cf is a ma.n aupv or- e d t o put a shot i n ordt:i to ~ c<.:l) the r oof f·, u.f0 . \ t. . '."'~l~ tho clistunc e from the ro of, ,1ould not a.l \'1a.ye have much to d O \':l th t 1"'..J shooting of t he roof. I t C:opends on t..YJ.G cou.nt of wo rk 'Lho.t t h e 1., o ,1 d 0r hus to <lo to re l ieve itr·o l f . For ins tu.nee u b l ast may be p ut ,.vhere it htis t'l'IO open d des Yr.en th•:ca uo·J lci. only he t no ~i deo to break ' .n<l ti-:.o . 1,o\1d~r cou.ld be de:t,oeited almoe ~. to th~ roo f' \v i~hout urEs:xrii; it doinc c:ny dW!l.ti..:_:e whi le if the ho le be t i ht tl:io IJO\'Jdc r oould bO 1 • •: " er G11 ·r:-rom th~ roof' :.~ncl 1.1:·Gak it. i• • v �Q• '\'1h c n, a.o • C•\! .. o r l\'.? 1 f 1· n r.., -·. 0 7 .,,,"I -'- r.,,, Cl )' J A ,u_.u..-•• •tr"· A• l f'.e f "M., t 1Jnt ry? r ?I"~ ..., . -,~. 1,. "'" =- V . ,, • • ' I o in vl!.i. ri ro e, m 11h 1·e thir r.u.. n '.,LS "dl l u ,r ti ,.,,·t \ ,f ,; . t ·•..: l·o you c:.,,.ll ud ui d ~r? • Y :.;~ t: i r. Q.• v,u..t room n us it in? t- . 1/177 "·· ''ht!.t c.i d 7 c,t1. l,C e 'h ;r.~o '? _I\ • -:,, , ,!l un ,_ ·;; r bh t.. cock a c; . .Oo y ou know hO \ / hD ~u ~ 'tht, c J ? .I\ . wo , I don't. I su :,p oHu tryinr; -~o r•·c t <Jut t...nd :i.t Cf UCht h i m11 1 Q. Wcr; i;inythinc: uo·ne t h., n~ bofo i~r.:: rou e;ot in to t ry to 1:J.:Jt h im out, ft. . Y :)c they J1c...<1 D, :;,ro.1,; un.clc r i,11<.a 1~oc l(, ux1d "' c 0up l t Ct,\?Z as if tryt to i, r y tht., rock ·.::han I cct t }11.,;.~G ',l• 1·•ur: t!1.d:"(;, o.ny -3.xtra 1:.r oi,e in 1-,11.,i t rocn ? A . Y•.:.B th, n: ,10r"c.: lJL Jn ty of 1>:coy s i n l,h,, r·c ·t:-, ,._, C..v y i; ofo r u .o. ::-umb" r ,,..h ,, t r,i;;,.c }} l'01J5 ~1 . A.'4 -1 '6" ,.:md 4'8" and l nrf~0 C G(t1 1, i 1:1C i.!S f. . Ho,;-1 1~.ich is tho c oo.1 th~ ,·c? ," • f b out 4-!, 1 • f·, • T)id you help 1)rcw..k /l • t he r ock tc '!:et l 1i m <,ut'? y :.u h \.. d c-o.d x1hc n yo v. ot ~-,i 1(1 ou ? A • Y :~t1 , -: i r, 0.• Who ,:v.s in the room ahcu.cl f ye,1; . f . His vo.rtn 1;;r v.nd. t"l>) E:$0 ot1~i:.;r t •:,o i•oyc. . • , ~o·.. lone h,ive y-o u b e~n uu:ckin. t ' ..Jn,? l • f,_c:mt -c, ,,o •·k •·h e Gth of t l-tis Mc. n·t :- . ·..:. • •'i.'.5 ou r)C; 1.;n up in t heir rc., r,m b\.,1'u re t l1 i e ? 1·,. !'.t•.v •; I'" • ,..,, Up ".,-~ h re 0• v v=> .L. ·~y c.i.v ' y o net:: or t· ,,1 C (J ::;01:,0t i mc.:s mo c 0 for G o r '7 ,~: ,...s ., ,]~.:J ::-oof 111 o r c tt~ t:iu f c, c0rr1<...l .i on t h.0 dc y hefo .r·(;. ? 1'} r1i-,vf . . . r 1..ook uny ,, r i.1cu L,.r no 1.-i c c ol'hoy hul ,c o·, e t rr 10 1 ·· · ,._ to G.10 ...>:.cc.;. - --. , . ""l :,.._ 0 .,_., • • ., �• J ...mo 1 • :i: . i, . · ,11.. : c -..- , j_ l .in •.• no : ..l. , ,_ , , , ! ., ;t v ;.,,,~ .. ,•,11 vo•;; • ,_ t,n e. ,nc:r ,o knock J. • l.:1c 1 ,,ro , 111 ::,'? . d. 1.·w,ck " I VL. , .,, . . ::;hot ui \i, r .-... , u, ; r ii '.i i, H , knlllac,,t - ·:, • t I ol:ould. judr:c the ur iG1Jf.1.,ni...it i t vy t'O,, ,...-1..,v ·.J c .,..v.rh 1) " 0 ,,,·o,, .,,, , .. ,-.., •n• ,.:.. , not cl ,r do ,.r . ·.-" ur;cd it fo r:.. pr~· • 0 , .:· ,, •c.. t ,,ro)! i n ·,.r.~n ·" u .. oxi< in .. o t he ro o,n? • ·,. e. t o, ; tic ! , It ,,t.G ! i nt 1i n · be •, .,0 ds r,r, cs incline frol'I the f :..cs• a.5 1 t hud -, .,un l01 ook..,u • i- c ,.. . " .cc,,. It rnuot have 1 •·.. , t., • ~ .: r-ocJr on t''v ,~vJ? ~- llo, t:: .r- ·.,1...c c~:..l 1., ; t, ,.._v n tho rock .n d t •, •• ~ 1. 1> so t l:u.t it 'b \,;n iht.. r;,"ot 'v'·,1.-.t Krock .... d i t. ,,t e, r l vc: ... n u. lrn.d 110 ,;f ,·.:ct on i,h.. re ek :J.t ;;.1 1 on1.;d tr.ink by J~u.x·.iull• <:.uentj ,: . Do ~,o:.i it , ,. uld 11(;) , or,• i h lu f c,r L ,,o.n to n oun d t'.,1xt rock in th..: condition i t \1DO c.md th:i.nk i '., ,,u..b ~<lid c.i'tw r the shot • hu cc,v l o . I ., co"i.dc.i no .r .t V G hu0n ~;o li a. . :rue • Y<.u . l;n·i out , rid ~- ot -.,111: ur i v .r ·;-, .for'.; y ( u tr-i 1.. d it? • ry iJ ... r m.. 1· c..lcl . /' . : .,,.rnt off? 0 , I drn 't 1 1 11 , ,· ). I _I : - -·- - - - ,\ I ' \ f t �; ou c ould h uve Y•.; St ~ rr • y. '·-. I l o ok0cl i;o L"lC like t r_oy had 'oBGn <'· . :)id y ~ v. no ~i o c ho ,,r h i gh? ~ ~ i., c, one 1-.h ..n·0 I don 1 t believe m:.ta ov,:.,r 3'' fro:'.! t 11.o buck . C:.· ~on 1t ruu 'chink t hat had hud somd t r. in6 to d.o ,: ith br ing ing tr.is rouf? A I "\"/OUld not 1)e surprised if it did. The r·o of VlV..f &11 _, OY/ d ~l~ Q.. Ho,.-:- ·;.en.; thG 1.:.ro_;_}B in t h"'n: wh en you • ,;nt in? J' . 1 11 ri v.ht • • Tl• '•''h0•·~ r;~s tho n t;;,,r Cia t pro:o:::; E. tund inc; wh~n you l; n t. in L.hv r·-:'? • flta.ndin g u.p u l i t t l t: t o thG ri -: ht hund s ide of i.hl- r oom :..s y01t: go up the fc..ee -I 1l • I o t h en:; uny c e rt u in di a t unc;,; t h.u.t you a r e suv1.;Or, cd l;o 1) Ut th.GI 1;ro1,s in th1.; min.:::? A. Th~ way I do i'a to .1.,ut th~m whc.:revur I n 0:a d thGr.'l• q,. I El t hat thu onl y rul \.J a. rnu.n is su.1,1,;os ,Jd to c; o l)y? A . I t ls tha l'll?G t r ul G I t h lnl{. r.• Di d ycu no t ici.; c.1.n<1 cov.l bt.~clr vf ·Ll'.v cur ther~•? 1 �.•· k eup the • lo r o o t, . yo u l l•n, ! • , • , •ctr 1' . · c l i c.i. , , : ~ r Y t.,. I ,t,!1 1 t ·~ • )o;. " ut , . -.. 1 ·,·om t; " t o 11 a f oot ,.,ould ',h,:t not L. t vi n L; it in .:, urt 'lilt..: rolf 1,o .. v.t i•c in ;j '' f ror:t 11,r .' i r .. ~.1·~ n 0 1- .t.,'.:-,o. .1i,~:. ~'Cl •~11._,1·0? ·~ • • . ~- cJ·ot i a n~ <,_..,,.CJ. 0 t, .... n . ,,l!".k' • ..·t"n l ,. it• .cock? ..11 .. c.. ·i . f:·o!?t ,. n r,.,..,1· th r \ , clr? J-, 1., \,L , ..,, d 1· ,, 1,,· \'l - iC,':• . 1 , •. t1 .__, f t,.C-., o ,1.c .. ,;_r. h1.. l ·:tn,~ .. ':...:!l .,ct.\.,,, hlL"l ._·(•<.,.... 1, 1 :., i (.l_t;: 0 f nc; · ',(,,- l ei. , :'L? Lyin ·., i 1,h Ii::~. f· c. _i ' n co1.o.l on th. ri,jl • l"v.S ,~}:.. ·c c,ck c,n :-io l)OC.:. r of' i :: c ·1 t,;~ ., ~ .;i:.C ~ u .iUQ co v :r~d ...11 QV1.,:· . Did -, r . :!:'lykcc c o u :i..-i , r, :. {/1., ;tr,u ..}1~n , ou fi rot Y~D . . - JS ir . f r o~ t.h.:: ! ·001' C:i u ;- ..; t l.!11 _,ou •1,0 crill che -1.l<'l i~s? <1. Y Ho :, f:..~· 1 A. :r-.: did !"'<11, c:.. :..r1.,rt~ ln_: 1•, ,t jt •• Ht. t.ck vd if I •• 1.,rked i n r mine l1 c..nd n<h, ,·r,t ood i ::. J.rv.t t'.~o l·o l t- in otrt:~i r,ht er elc>.nti n1,? "u • Di d :oykeo tu ll y ou to lace ....ncl , ck..;d if I v r •. •o rk0c.l i n - u mi nc , A . II~ onl:~·· ::.::10-.,c.. <1 mu t ', 1., of your c <1 1? 1 ,J ,' . HOY/ h i c: : ins the f ..~c o J, • J. h OU t 4.-~- 1 • 0,u - t ti <in d. h~r L '1 J t on. in th,,r.-: ou i'ir;;d ,, ::..JJ 11r ~ t, ty noc.rl y 20 11 of ( . JTo•.1 co..,o it come Uu,.,t "th,. t ho l o a ho l 0 h :ft in the c olid • A. I' i nc.. d 5 1 t,nd 1·ut 5 1 ho l e in , • Ho., dJ~P d i <i you 1iut tp. .. :i,,o l e ·v•~-•• 1--..'? _h. • Ju:.:t th.. :1 ..m0. ------- ·- - - - - - - I \ �I n--}J.\,, :,t. ~- 1 c,, ;.; c.. f J ut;,11 D Lujo.n , u li us .u .roi•n r .,,:.ro k ill.:,a in • o ? 1 7in.:. , T!o c k • ~ ,.. _, ~·:i.n[D ,J< lb '- J.j' 1 : "-..J tl •q 1 • 0 1~ G,. vr}tor"' cJ.o ,.\, c • .or}::':' J . '~o ? • inu Q.. 1)ie do u.l'? t • y ,2 fl f' :1 r'~ Did you kno , J ol!ll :ruj,n'? • • H"' , 1,.::. Y . _Jo.rtn~r . • .. ''l'l,0 'he .. o r ki'l'l~'. "w • \Ii h ~Tvll y -. mtwruc:r? "·• 1'1.,; c. 1 l"\i r. Q.~ - 1'1.::..t t i L'lO of du.y di d h.·3 c;et 11urt? J,.• _Abc.ut t,;O lJ 1 C lO CK • r • Ho .-: u i d he , ut 'h.urt t ~~-. to? '1 . llt= r t a rt..::u i.o ;,,ull n ul;dll:l t.n c.i t'rt ro ck f 11 <10 ..n ° " • rnL,t ,ro.s 1-,e clo ing 1H.:ford h (j . u 1 1 ... cl the .,,..,._d l 1:-? >. ? I cni,to at some. 1:;14.1:lhf t.ncl r~ r· t,.. ct"' d to !: u ll t r.0 nvt;dle. (~. ' '!here d i d y ou ooe ~rour .i_.- -.' rtn 0 r n...;>' t t i T'h"!? fl . He \,t•.s' do 1, n on tho ri :;ht h :.~nd sid e of the roof'I un a C t l }.ed me 2 or .:i t i mc1, --y,: .rtn ~r. r . ;·'hr.. t ,. 1~ ~, ou do th ,n? A Tri G<l ! o lift t he; r ool';• The ro ck ,8.6 prc:tty b i c n, I c e l...ld do ooi.li I ,,on t to 0 01:. thu f,;: l lowo .:ho ,1o rk1,; G i n i)::.d n ex t !,,luc.J .. nd c ul l ud th1..,:r.t. •:.• ~but C.:.i d th.;y do ·,hen they c~me i n? ,..__. They c,m-.: ~o hol1, me-- took c,1_ h .... tch i.t to hr-.,- 1< 1. '"'1.: r ock . One of tr.e f1...ll0\.S --l,n ,. t o g ~t i."nvthui~ f...,llo,, to ·!•cl !-' • 1_. 1. 1-.c.i. ;,rc,u J. l un ty of 1.;!"O!JE> in t hu;t r CJ01J1? • Y .... s :.; i1- • r _. Y11tcr"(; a.i (t :_,.ou ...,u.t in :.11 1.H " l u t rho t ::.! ~rl.? . :'. . In th... corn.:: i· • • }.ftl: r th1..· t:hot f i c1.;;d .. t.t r i a .10 1.. c.o? 1 . Jlt e d i nn-.;r ...ncl iv" ti ..,L-=- foe t!, -.: t :10ke ~o •1.;;t 01h • ".• . \"ia.a th'"t ro ck a ll richt h t. f a i·...; . ' O l fit•-..o. t.l',.; · hot? A. YCf.. , I und "!.'1Y 1~u.rtn .... r Go 1, t~ ... ick ..r1, :.:. , un c.:.ed t.111.; ro of a n d it s ounded ull ri ~)1t. 1~ . T'.' t..S th-.; r oof b..ll ri c;ht c..ft..;r J OU f i r e; d th.t. f' hu'v? !)i d yov ::: ound i t O.['U.in? P • Y _i , it -_:..~& u.11 rie:;ht. Hy p ..·.d tnvr c v~ ~ l •ohind me. I -.;.,n t. t o ge t r-- OM.8 S 4...li h f • Q. Di c.L ~rou ,,ut b .,,ck i n tim~ to fl ee t '-1 .:. rock :i', 11 ? '?hen I C L.1!!0 ·"r.ck tho.::: ccck "'3 11 1,r3tty clof;e to ~<, . "·• 1)id not l:i t . •: ,:.? • :-10 C'ir . r. tr.) : on cur· .... :-rru 1· !'hot die not 1mock (4n.Y of t he pr. ops de . >1 , A i . :"'o r: ir . Ct. • ...,~r,.; ull triu 11 !"0:pe up :.hen you e ot be.ck? J . Y .L r· ir. • You c it l"01; J.:..rio i. . • 'To :. • ~ i <.i. -he cock •.::w l oo:;. _? ir . '"OU h.UYL. :;_:l c.:n·,,·r of . _,ro1Js in ;:,111: r eam? f? Y...,e Lir . n o ., c loe_o i;o 1,he roof di d you !>Ut your l o.st shot t111:. one 1,ou f i r ed1 I • A.re. ut 3 11 from th.: re of . If you ::., u t t. hol e i n the mi a.dle it,, ill j ust br\j u.lc '.ne co t;.,l un d 1 . . . 1..v<J i l, UlJ a.nci i t a pretty hare. t o i ck ~ i; do .n . '~• .) i d rou ov -=ir .,ork in c., coo. l 1~1ine 1n::tor0? 1 • £ _e fiir, I n Co l orudo . Q • Ho1;1 l onG <!.id ~rou -.. ,ork th,:, !''d? (1,• 1 • .4'v.;Tt ~> 1-row xx ~ Y •~i.1r lone )1 u.ve / CU ,10.0~.;d )1 ._ rc:'/ I • Al)O'...t t.JCJ •.: c: •J!CS ,u·• !Io,1 f ~!' f r om th... roof o.r c ~/c,u su!.,1ioa e d to :.,u t t. • / J') (; u t •J " in a. hol e? �' i kc J n.. .nko .:..,1 .. : i , T , :r,uj ...n. J f"-'..,..., r "'O "'o :!"1-.1~ 1• n . r~ ~....n·u.' v i :.1i nc tb... c,.1::u.d 11ody a--rid yla c c of ecci =--~nt t'.nd h•~r..r inc hLJ:iro: ~1·..:: t oti:11(lny of \ Ii: nc:::G :o i!l for C?\,d.:-t,.c.t-.::r count:,, ,..t~ t,1;, c"'~ , do fir:d i.h..... t th0 sui d J u o.n room Ho 1?7 .,.~o ,; J~ntr y , · ·o 7 "'it10 of J':.tJ Union p .:.i cific Coul Co of P.OcJ i'-llrinco , r 1rorainc , frc. ""l i:n,iuri co r 1.,c~ i v:Jd by o, f u ll of rock in r·c.id r oU!::, . ii,; furth!..r holi1Jvc ·,!1~ t..'~ ov..: t~ b--:..., cci (...t:ntttl c.nd fincl no 11l rnn0 ..itt,~chcd 1.o tli~ Union pccifio Cot..l (,or.11,0.n y o r off i ci c:..l s . 1:.,.,k L•.,c.r on tc,·.,n oi" ( f1 d) r iko J Do.nko\,CY.i. Co:co:.·hJ o �rrI i; uNION - Mine No. OF PERSON A L I NJ UR Y . 8,sf'ORT ••••••••·•·•··•···· . ········\------ 8up'ts No.................................... in~ured, N(l.111e n)6 Form 123. PACIFIC COAL CO. (J - _.{)_, J , ~' ; l i.~-~_ of perso11 :.1..._ /'X-c---7~ ,£_ct._,.·---o----· " _.,ex-r,_,,G-/ .,, -.-!>- ,,, Occupation, 190 ~ T;me ;:J. o , ~ ht_ Accident, ~ ~ t ~ f2I oatc o,f /-;) •. ~ - ' I ? - - - _,?/-ii . Mina No. / E11 t , ,(• ry No. ---...3 Room No. Loclltio_n,_ . J~;~ine, ?fate where, (/ If not 111J"' e 1 fltr/11C O Mine Supt. I •• , G? &,u2- ~ - ~ ~ d ,./ p ,rs0/1 mJtllC , Aae o, •· . 111at ramify, if m,y, 1 in employ, of Co., HoW /ong r {Zh!---=--~ Name of Mine Forman I _h,, (? • • 0 ' f Married or Single . I ~ 1 7l JI / ~ /• ...,_61../ ,,,? • 1 ,? ,,..-<./-c._ .,._,_7__,.-,;.-~ .. J.-..,,......, _....,..,_,._ ~ J ll / t. -, ,. . - . Condit,011 of Life or Circumstances, / ddress of nearest 1u111g ,ea tue, ~ P --.,,., ....,.~_,.~ !Jame and a ~ , e.ffioient man, ~ •-<---.-_.z....--Was he temperate, ~ was ho all '.JJ' .., .IJ ,.., J I din whose charge left, ..Y~-R.-~./ ..2& ~.,,.,,,..,,,_/. n _ _ 21_ _ ~½~ Where an . _ . ~ -~ ,-1 Physician called, if any, Name o, (f;: .........,.~ l ' F " L < = o Adress of Witnesses. Name and P• • Nature and extent of Accident, .I ( (Signatur e) Oate 1 �rrJE UNTO pJSPOR Form 123. N p ACIFIC COAL CO. Mine No. ........ T OF PERSONAL INJURY. 8up'ts No. ft~ ,., Person injured, t✓ama'J0 . , O- ~ P ~~ 0ccupnt1on, /' 'd t ;,,---e-/ oate of Ace, en , Locatio11, / ~•.,. ...._ ~ . ·ured in Min11, state where, If no t 11IJ Name of Mi11e Supt. Age of Person !njured, What Family, if any, ··········------------· 1D(r.J Mine No. Q,.e/: CZJ-,_~ . :_:i- 6 Time / ;L o ,...........e.,,._~_.... Name of Mi11e Forma 11, ~~ ./ r Entry No. q, ?-_;y Room No. /J~~ ( A ? - ~ Married or 6i{gle d__-_,_~ 0 How Jong in employ, of Co.' ~ Oo11ditio11 of Life or Circumstances, - -address of nearest liuing Relative, c:::::7 ~ _/ a/Id Name ~ ~7 was he an efficie11t man, () Was he temperate, ~ Where and in whose charge left, oJ2..-v. c:7'' (9,, d-c::z.-.n..,_.~~ Name of Physicic1n called, if any, .6L---z;, Name and p, o. Adress of Witnesses. Nature and extent of Accident, f ,1/ (Signature) Date 1 Title, _:__ _ _ �~ oN[O Form 123. N PACIFIC COAL CO. fflP __ - Mine No T OF PERSONAL INJUNY. 8up'ts No. J~ I . z,,,.~ upat1011, occ oif Acc1·de11t, 011 t(J .J-J - r>--· C < _ - / Locntioll, /-'- ~ ,-.. . red in MiJI(', state where, If ,,ot 111J" ,,,,11e of {.1ine Supt. . . I ,; Person nl}urec, Age OJ . &, ✓ , -;, 7 , .::, •••••••••••••••••••·••······· -~-~ ,h~f ._/?f"'J/YJ : \ -~ ,; Person injured, //£Imo O'I ~48 ···········~ J?6roR ,,1 I • • • ••••••••••••••••••••• ,J.- /,:;, ,,,, 190 o/" Time ~ : 3 ~ Entry No. Mine No. ~ < - - < . - - v - - ~ Name of Mine Forman ~ ~ -~£_ =- - r/ M 1 , •d b / J • er, .J71, 0 ri ..) -;;?-U arne or mgle Room No . - LA:::::,...L~L / ~ -c---c ~,,_ ' , , , . _ ~ V/hflt family, if (Jll!J, / long in employ, of Co.' 7'/?>'r-"'"7~L-da-a..✓ - Oo11,lilfo11 "J 7'r-1'--ti r, j , 'Jl, a, 1.1m:Clfi1u1.a11ces, z_,, )h / /1 How and address of nearest liuing Re/atiue, cfi~ , _ '7 . ' · ~. ,._~ //J-,U/r~ ,A· /lame e-«icient man, , was he an 'JI' Where and in whose cha,ge l eft, 3/- Name of Physician called, if any, -~,_ :..<--a- _,.. ,_ ,,_/JJ _,/ . \:7"'".C _ ;J @. M , ~~ '--" Was he temperate, , d ~ - e:>L-. ·r ,+ • /2/ 1~ n.__...,;,Y£--.,,....,..._e,--~ Name and p, O. Adress of Witnesses. Cause, (Signature) Date C-7-lii-03--0ll. 1 c. ~ CJ_.,._~L~Title, ~ ~~i=;- /I �STATEMENTS OF WITNESSES. " r' .. e I f , .. ,1 ., ;i '• e ✓ , I ~ , r ;' . 'vi .,,,/ / t2 .. ' ·< �STATEMENTS OF ,VITNESSES. ,• .? . ~ .e ,. '· .' . . • . • " ~ , I .I:;. l .. . e ,,. p ·-- -.:!' <- . t.- ~ JI - _.,.I' /- ; · r ? ;f' ... ..; ✓ ;;z .-/ I , ' ~ �STATEMENTS OF \VITNESSES. • I I. . , ,, I ·• �STATEMENTS OF WITNESSES. l.t ~ ' t. j p , J I , .. I I �4 Fonn 123. tJNION P ACI FIC COAL CO. 1HB --·-OF PERSONAL I NJURY. J?HpoRT Mine No.... ············--·- 8up'ts No ....... ·• ··············-······-·· ~~ if Person injured, (lameo YJ1""'_~ . - occll/Jation, fl,-,.,.._.,,,,_.__.,'-;1' /~ _A ' ~- / ::i ~. ✓, 190 /foa . / d ~ !JP---:J,--~,_,_._/ !/line No. Locc1t1011, o .. red in Mine, state where, If not ,11111 te of Accident, e:i- o1 Mine S11p:. (lame ' ,; Perso11 injured, G. ,,.v"/J: @, - ~ Time / Name of Mine Forman, Q _/ P, q, ,:;._ ,, ' - - - < - ~ Entry No. ?- .JRoom No. la ,,,_f // ,:;; ~~ Married or mgle AP~ . _ V What family, if any, .. . 6 long in employ, of Co., .--,.,..__,..~ Cond1t1on of life or Circumstances, How 1· • R I t· e a we, U-..-.~ 77,., ~ /c:: a_. ~ Name an d address of nearest wing ~ I •1 was he a11 efficient man, Where and in whose altarge. left, Name of Physician called, if any, /.,J,J~~- • ~ Was he temperate, /71 ,- " ., , I', .--,. .,,.. ~-----f ; Lr r y , - t--a ,,.,_ -=-f ~ - -1/, rf , ( '_.,. / / .--c ..,,~ -ne... ,.,..,,t--cf, Name and P. o. Adress of Witnesses. Nature and extent of Accident, I' C-1--v--"'-<-....,, ~ --C.-·a .---t.~:.e-~~_.._...,_---- (Signature) Date { ~J 0 .-i,---d-:C /~ , .?- J' �~------------r nE UNION~~c_r_F IC COAL co. Mine No. l'orm,... :,ORT OF PERSONAL INJURY. J{6l II l l 50 •................................ ,-~ \ 8up'ts No.................................... name of Person i,yured, ~ ~..-o-c-" - 1- c....- d , _ ~ occupation, 4 . , / < ~ oatl! ~f Accid~ J;--9,~-~-<-j ,-____? ✓,, Location, ~ ~ ~-j~~ If not injured in Mine, stateu6here, _ 790 Mine No. o/'~ e .,, o / ..:? r1 7 ~ r y No. - c-(, q, Room No. z C?L ~ CY-.:,.Z.;-_:.-4Namc of Mine Supt. (-/ ~-v., •• , ~ .,,._ ~ Name o f ~ Forman, c/. C(. f_ Age of Person injllred, ._:1 '/ (r;JJ'-~ -?--2---· · Married or Single • CZ/?~,..._e-,a/. . ;.f / '£,/, · >'- ,;). .fl(' What Family, ,, nny, / How tong in employ, of Oo., -.:,- ~ • ~=-- Oo11ditio11 of life or Oircumstances, Name and address of nearest liui11g Relative, was he an efficient man, ~ , 0 _ _. Where and in whose charge left, 5¥,j_ ,t, ,· ~., ,• ',... '7 Name of Physician called, if any, C 'C(,) /✓ f 1 Name and P. O. Adress of Witnesses. Nature and extent of Accident, ----, (Signature) Da.te C.7.IG.03 7 ··OU. q, rl,.__=, ._~/ 7 Title, . ~ k '51ftrU-~ ..a �STATEMENTS OF 'W ITNESSES. ,1 "i I !, : / I I I I i I I ~)#::~ }/-~~I ~~ �Form 123. UNION PACIFIC COAL CO. 1116 -> T OF PER S ONAL INJURY. J, /41 Mine No. ...........................·······-····· J?n'PO \ 8up'ts No............................... )::_f -1 Person inj ured, %-~ & L I 0 Name 'I_ ~eJ ~ occupation, ..z;L oatc of Accident, ~ / "r. 19()--...3 Time / ,' ,3 t) o ' - ~ Entry No. ✓ Room No. Location, ~ 0 7 . ~ Mtne No. / . t iniured 111 Mmr, state whe1e, ff 110 l q • »(, Y- l ~ II '; 'J (lame of Mine ~U~Jt: ~di..-(/. Age of Person m1 111 ecl, J f, a ~ / ~ Name of Mine Form~n, A1urned or Single ~ ~: r--~ What family, if any, J'~ How tong in employ, of 0o., ~ ~ o n d i t i o n of Life or Circumstances, Name and address of nearest liuing Relatiue, ~ , J I - ~ , , ~ ~ - );_ ) ? , ~ was he an efficient man, ,..., / ~_ Was he temperate, ~ • • Where and in whose charge_ left, ~~ ~ ~ /~ Name of Physician called, if any, --&v, f:;p #, ~ ~ Name and P. O. Adress of Witnesses. Nature and extent of Accident, Cause, r~~ _,,~ /7--------J 0 J,, ,~ 7, ~~ ..:? ~ ~ ;;z,L ~ ;-/ ✓4 / ~ ~L~ . , : _ Q ~~ ~ d ~/ ~ ~ ~ -~~~ ~,'L-,~X-/ - d ~ ~ d_ ~ , ~ (Signature) Date C-7.ir,.03..011. 1 Title, ~ oi: ~ )z_, ' _______ ______J I �STATEMENTS OF WITNESSES. ~J µ~~<--~ ~~ __c;_~~, ~ /4~cz:~ .d_ -,J'_~~ _cL~ ~~~ ,L _,__~ L_;___ .; L~ ~~ _L ~ ~ / ~~ ~ /l!~c1 -~ ~c: 1/atureand eitento} ,. I I I I ·r ~;{. I: II I I I •1 I id ~ Cause, .z ; ' C-,<. -r-~ • .,.,J, �r7;--2 ~ .~) Form 123. THE U ,..1 1 " REPO RT roN PACIFIC COAL CO. - - Mine No. ........................................ - OF PERSONAL INJURY. 8up'ts No.................................. .. Yo•~ Entry No. Hameofl,fi11e811pt. ~ - Aga of Person injured, ....:J f1 ~~ NameofMille Forman, ~- - t/?q, Room No. J. Married or Single _:}j_ l f ~ ~ • What Family, if any, How tong in employ, of Co., ,;t --;;n,-c..-,--,,,,_ 7 ~ - Condition ot Life or Oiraumstances, Name and address of nearest liuing Relatiue, ,,.1<---z-~ k ~ ~ - - c;?~ ~ was he an efficie11t man, ~I ~ . . Where and in whose charge_ left, .Yrc e , - r- ~ Name of Physician called, if any, Was he temperate, ~ ~---..CZ..0'?.2..-G;&-z:~Y , Name and P. O. Adress of Witnesses. Nature and extent of Aacident, ~ ~ --,,__,, ~ ----L ~ ~~ n ~ -~- Cause, <--~ ~ ~ ~ r ~ ~~y ~ .• (Signature) 1 C-7-1&-"" .,,.,--on. ~ I ,/ ' �. 0 i;- 0 ,o ('I 0 V • ....., IJ ~ 0 • ., 0:.r ( , ..ht•,t • n ' • J' J. • ·:: !-:. t.• 1., CL '\ j u ~tiJ ., ..{; , 111 1..,. !v l.{Jrl .11\ l . t· i, • :i •. .>,n •~ 1 i .1 l C. 1: : ~1 .., J ·.' I v \.!~ .in? ., : 1 1-: o 0 ... n ., ' ,:,, i , •t• i; ;01c.;•., .. ' •.. ~- f ,I.,; c.l i r :!. ,:i !'l/ • c.; ~ . l • ha l Ji n 0 c n t, :i, •- . 1•.o\-._,J.. i[~ ; ,, YL 11 <., .. , •• J..:, .lnc L•ri 1,}· • J. . , . i .•~ n J IJ 1· ' • \ ·· no .' \: ~ t ~- ,_..., l ., rt . 1-m .:.:1t.!.~ r c, ,.1 J~ , .t, _ ,.. l.!. cm 1 :U.{? ,<,• !-i.,J 1 ~I. ..l, ~):id !ht, ~-, . .. . ~re/., 1,ii' . .. u; II • 1.'l(J', 1 (1.-.s,1,)I.! . .. , . 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J?Hf'Ol\ T ~ "· ~ (j_~ • /.. /?~~ occupation, r-zl ~ oate of Accident, C T ' ~ i f . ~-1 ~-~__g.,. ~ Location, vr.--'= ··/ ..1,red in Mine, state 71ere, If 11ot 111) 7 ~ Name of !,line ~u~t: -~ · , Age of Person ~nJUI ed, _ 3 ..:i ~ 190 J..j- MineNo. l Time / (l : -.3' d q I /?(· Entry No.~ ~oom No. Name of Mine Form~n, ~ Marncd or Single z? ,,,/0 _ . ~ _ _ ~~, ~ • r~ What Family, if any, ~ Hotu long i11 employ, of Co.' ~ o n d i t i o 1 1 of life or Circumstances, Name and address of nearest /wmg Relatwe, - / f , Cf:--~ ~~ c.--: • Washeaneffioie11tma11, ~ h e ~ e m ~~ - - Vlhere and in whose charg~ left, ~ ~ / •- ' Name of Physician called, if any, - 0 . ~ -:J:/ Name and P. o. Adress of Witnesses. Nature and extent of Accident, (Signature) • Date C-7-16-03--on. §.,3 8up'ts No.................................... . person injured, Name 0, . _ 1 j,vo,7!:~ Title, ~ <::3f~ �Form 123. ~ UNION PACIFIC COAL CO. 'fllP Mine No. .. .... . T OF PERSONAL INJURY. J?&POR 8up'ts No ........... y.} )4 ••••••••••·•······· q, ,-1 Person injured, J~vz;,..-,,__,,,~,_....,-Name 01 , occupation, -,l 790 oate of Aocid~nt . . r ~ ~ -~ Mine No. . - ~ ~ -Locat1ot1, . •urod in Mine, state here, ff 110t Ill} ?;J.~ /l(IIIIO of f,fine ~u~t. + Time J7 ,/Of~ Entry No. --.:? ~ ., ,.£ · / q, ?Pf, Room No. q, 62., ~ Name of Mine Forman, ~, Age of Person 11uured, 7'-o ~ ~ M a r r i e d or Single .::>7;f., , -/ l'lhat Family, if any, ~ - ~ -,;,.,,__, , I ~, How tong in employ, of 0o.' ~ ~ ond ion of Life or Circumstances r /f ,/I__._;,__,,.,,,-/ / I~ ~ ,,!_ ~ Name and address of nearest liuing Relative, .1 - --- · -7 , ,)7. ~--~~ / t:A--<7~ was he an efficient man' '!.M-, Was he temperate, / "k.a___f__ ' Where and in whose charge left, ' ; J r ~ ~~ ---t //~ , I -~ Name of Physician called, if any, @..., _.J if~~ ' zj~ , Name and p, 0. Adress of Witnesses. Nature and extent of Accident, @~ \ (;1. b Cause, a c1o-L~-../. -,-,:r-L '3 ....,-?L, , (/. ~ erZ°P_, c;f rr____,.._,.~ ,b. >~~ /~~ /(, 7 r- d~., ~ ~ ~ ~~ ~ ~ ~ 4. (7 ~~<--</, ~ ~ ~ ----- ~ ,-r,, ~ 7'-- ~ rr,~ ~~ ~ ~ -L ~ ~,~~· J L._,_, ~?/'~ ~~ 7 ~ ~ ~ ~- (Signature) Date C-7•1~•03·-011. 7 o8:-?J1.~ Title, ~ u~, I �Form 123. ~ UNION PACIFIC COAL CO. fJlP F pBRSONAL INJURY. Mine No. R6pORT 0 ■ •••••••• • •• ••••••• •••• • ••• ••••··· 8up'ts No.................................... ,., person injured, , Jc/~~ / ~ Name 01 ~.A/' occupation, . a: ~ ..y-- d <7' ·. _ _ - - •• / d 190 'r Time 1 Accident, /;}-0,--4-~. 0 oatO 'J ~ ,,,,;,,,--;-,. Mine No. Entry No. ,;i.. ?- Room No. ' Location, I . . ed in Mine, state w1,ere, If not 111}ur A /- i,; _ , rr- .1 t,1ine Supt. Name 0'J I t. • / (}_ _ /A< _ r~ ,Married or Single ~ ~ ~ N a m e of Mine Forman _p,/; J - . - Age of Person ~njured, ~ ~ What family, if any, ,._...,r ~ ~ ~ H 1011g in emplo!}, of Oo.' ,;,,- ~ ~~ition of Life or Circumstances 010 , addrass of nearest liuing Rclatiue, c?'~~e.., . .,,,1 _ O _./ ~ / 'tJ 1 Name an« ~•--7 ~ was he an efficient man, Where and in whose charge left, Name of Physician called, if any, ~~ ~~ ~. _ ~· j.. e . Name and p, o. Adress of Witnesses. Nature and extent of Accident, ~ ~ ~ ~ _,£,_l ~~- ; /1 ( I f' f.t ( {), ~ - / (Signature) Date 7 Title, • ~ ;i,,, y _ ' r-r-r,~,_, , ~~ Was he temperate, _ ~ I �STATEMENTS OF \VITNESSES. �Form 123. ~6 UNION PACIFIC COAL CO. ra~ _ __ . Mine No. v U ············,· ·•♦ ---· OF PERSONAL INJURY. J?EpoRT 8up'ts No ...... . •·········--·-··••••• ••••···· ~ -o-;- if Person injured, Name O . pat1on, , f Accident oataOJ /;' 00011 . "r rt t.,,;.., ~......-c.,/' t d (Cp__e.,,(j~ ~ ~ v ~ / 0-- / ~,..,.,.__,,?.c.. t { =--.--.-d ~~~~ . . ,red in fAi/H', state where, ff 11ot ,njl Nnm• of !fine Supt. ge 'J, f Person 1/l)UYed, A O What family, if any, 1 ,1 ~ \ 190 #-at:; ·1 • ,me Mine No • I~ ~~ ~ j /J'1 elf_, '-<'- / }?-,-,...dL.,,<..fiama of Alina Forman, .//, ~ .r- a-r- c ,. - -- · Ma rne • d or s·mgle r/ p , ,,, __jl l 9?,. e..- ,;l- "' he an efficient man, uias Where and in whose charge_ left, Nameof Physician called, if any, r .,;;v..._,..,__-_~ ~ 7 , -~~ Condition of Life or Circumstances Name and address of nearest liuing ~elatiue, "?7~ ~ £ ~ How long in employ, of Oo., r 1 ' v rA, vas 11e t emperate, 2/.: o./ , ( ' .,,,,,-.,,,,,-z.. - d e • >L:~ - ~p· ~ ~ [/ ,J ,. , -C. t ~ a(/..,,. "/I..,_ . c.. a- ( {7:d,. -4 /4 _; • A-v cf, ..,,<.y' ':';ft, ,. ,, ,r I ~~ n ~ 1,. 1 Name and P. O. Adress of Witnesses. (Signature) DQte j. 'hf, c f ~ ~ Title, 1 ~ o£~,_~ �,. .. I' . i ,, . .. t, ,. ?"' ' ,., , r l ' . I 1• ,,.l.. "' .... ...., .. II l· ,c ,r lti . . ' t, .,,. :- I l,. l ' 1~ . .!.1? 1' u ' ' li l' . ,::, .. : 1· ., . ! • J q r ,0 1 ' ' . ~ t. C. c~. l n i.:.!'l- 11 J. _ I .,,r L n ,\ :i v - .i ,:, ..- 1 ••1.. l , ,. I . '(,t .. (; ·- • ~ t i '·· .. • I I . \u1.: . ! I~ :i �Form l'.!3. rrON PACIFIC COAL CO. ,rJJE UN _ _ ___ Mine N V 57 o. •····•·•••••••••••••••••••••••·········· T OF p BRSONA L INJURY. J?fif'OR 8up 't 8 N0. .................................... ,1 Person inj ured, (::: / ~ Name o,. ~ occupation, ~ oatc of Accident, c f l t ~ 6 -c/4Location, Cj!,-A, ~~__....<---~----q:-.:2... ·urcd in f,1i11c, s ate where, I/ not 111) 190 "f- Time - . ; , - o • ~ if;>?(. Mine No. ~ Entry No. / Room No . ,, .1 t,1i11e Supt. 4..-c--v • L -CJ ~ ~ _/, - -L, Name of Mine Forman ,...-,,·()__--....,..,. ~ _R1 • / (l//li, 'J ~ ~ 0 N ,1 Person i11jurecl, ,, f ~ Married or Single ~ • ~.;:, . o x::£.-&-.--.·Agc 0" What family, if any, • How long in employ, of Co.' / --?.v1_ .-- ,,..-r _C%1('_ Condition of Life or Circumstances, I ~ Name and address of nearest liuing Relatiue, Was /1' a11 efficient mall, Where and in whose charge_ left, Name of Physician called, if any, -- - , / ~, 6-z--~ Q _/L _ . ~ r LZ--~~ _ -r~ ~ ~rt--0~-o~,, Was he temperate, C,~ ~ _ . z _ -(/r! 77'~ /Z-v-,-.-f . Name and p, o. Adress of Witnesses. (Signature) Lr.nf. ~ Title, 7 ~ 0 ~ - _;; �STATEMENTS OF \¥ITNESSES. 11 I I I I I . I I II II I I I �Form 1'?3. TJO~ PACIFIC COAL CO. rJIS VN - - Mine No........·················---- ····- ... PERSONAL INJURY. J?5pORT OF 8up'ts No.. ~ ., person injured, Nnme OJ . ~-~£--, "7 :c-L occupation,. if-.,._,.~--.;L_,,~ 0 oate / Accide;t ,_.:z . l(lcation, . . din !,fine, s a te w11e1e, If not m1ure •r.. 1 ~iine Supt. Name o ······-··-----·--·-···- . • ired i-. , ~ 790 Mine No. ~-y~ a.,&--y 7 Time / G? /?/, Entry No. 6 Room No. y Name of Mine Forman ,Y '...?~ -e:z-.._._.-- M •' ., person t11JL ' ., ) t-7 ~ arr,ed or Single Age OJ ( -_ , atfamilY, if any, o~e.-/ - ~- , l'/h / ·;, • 0if Co . . R t· HoW /ong in emp O!J, ·' ,j , ~~d1'f~on of Life or Circumstances, I we, /<£-t.--::t.- ~ _ /7.,,..., __:r:1wmg ea ddress of nearest - L , . Name a11 da ~-rT"r~· _ ~ was he an efficient man, ,,,;;-~. Was he temperate, , 0 Where and in whose charge. left, __.$..,__,_,_l __ ~ 7 ~ -~~~ ,..,....,z;; _ ~ 7?,;- - ~ w U # ...... / / /.JA ...,.... - ~ A - '"'' of Phgsician called, if any, ,.,61..,,_,, £, -& Name and P. o. Adress of Witnesses. Nature a11d extent of Accident, Cause, (Signature) Dczte 1 -- ~c:S!Y~ , ~ - ~ �fJl» oNtON - ~'orm 1!!3. PACIFIC COAL CO. Mine No. T OF pERSONAL INJURY. p,;pOR 8up'ts No. ••••••••••••••••······ ········-···· person injured, 0.. ~ _/~LL-.,,,._9--o-_ ~ d " Name 01 ~e--v' • 7 pation, . . . .✓~ -¥- ,, 0cc11 ., Accident, /J '- , ~ 790 ~ Time Y o ~/!. a oate OJ -&------.......-v~~-,:::1._..........---r:::r Mine No ri E "'.-, ' -7 , . • ,.,,._ ntry No --R N Locatio/1, . Af" state where • oom o. , . ,i11rcd /II " u,e, ff not ''~ ~ ~ w 0- ~~ r Nameof~l3.1l@! <9 / ~ -,, _!'7',, c;rr..~ I - ""--'/ 7 , . ~ ;;>n_ . I -<-<-<--<2.. - -'-{ c.7'/ ~ I, ,f Person 111jurad, ;/'~ • , ~~ Mar.riad-.01 Bingle _M. ~ /=✓-::> Age o, . ;,,; c::T!' v ~ t family, if any, VI/la long in employ, of Co.' J.....,...,.-r,1 ~ Condition of Life or Circ1~mst nces Hotu • • Rea I t.we, rD d address of nearest 1,umg ~ - _ _./ flame an (2;_,..--o _____., ~ /, •,,r~ Vias he an efficient man, f - - /r . Was he temrferate, t7~ d in whose oharge left, / ~_, _.._.....~ / Where a/I . __e . _ ,,,-;r-- · ,; Physician called, if any, ~ . ,,,..~ ;u;,- -c--C::Hame O'J • {.fineSupt. 1' fla/1111 0 . , J A Name and P. o. Adress of Witnesses. Nature and extent of Accident, Cause, (Signature) Date 7 C·7-16-0:l-·Gll. Title, ' �STATEMENTS OF ·wrTNBSSES. I II .1 •t ' .. . I i I !. I . .1 ' J • .. L I I ' , I 1 , I ; I .,,· ,. . I I ,I .. I ,I I , ., • I . ' • ' �Form 123. tIIE U J?EPOR NION PACIFIC COAL CO. - -- - Mine N'o. ........\ ·············•t ....... T OF PERSONAL INJURY. 8up'ts No. ,.; Person injured, O name~ . occupat1011, oata of Accident, J~~ ~~ I ~ ~ ,, ~ --· ~ ,:;<;-?-r...--<,......-.:~~ Location, 190 ~ Mine No. Time / E11try No. ,Y-....3 Room No. If not injured in Minr, state where, Name of Mine Supt. Age of Person injured, ~• L ~ ,....,:? What family, if any, How Jong in employ, 01 Oo., Y~ Married or Single -- / tJ ~ Name and address of nearest living Relative, hr was he an efficient man, <...A,.-.,._...:::;,c....eA---e~....._, Cj? Name of Physician called, if any, ~ ~ o f. #~ Name and P. O. Adress of Witnesses. Nature and extent of Aaaiden» L....,,/--c", -~~.-e-. / r- o(_ (Signature) Date C-1-15.03..on. 1 , Title, ) - - ~ Was he temperate, 4 ~ Where and in whose charge left, ~~1' Condition of Life or Oiraumstances, ~, ,,J~ oef?-& Name of Mine Forman, ~. , , �yt,2 Form 123. NION PACIFIC COAL CO. THE U Mine No. ........ .. ··············---- - F PERSONAL INJURY. RBPOR T O ., Name of Person injured, ' 8up'ts No. J • #," !}/.~z:::-, occupation, ~ ~ '91~1 190 ,.; Accident, 7..£'../4-. , d ~ ~ oate 01 ~ f) , t , • - - -L. .A I f ~~ Mme No. . Locat1011, 1 If not injured in Mine, stat where, i- Time / / q Entry No. 0 , ,<_- ~ h q: »;, f Room No. / £ _2 ~ r ~ ~~ Name of /,fine Supt. Name of mine Forman, (}_ .,,... Age of Per~on injured, 3 / ~ Married or Sing,;;rd;._ _... f a What Family, if any, How long in employ, of Co., ~ ~ Condition of Life or Circumstances, ---Name and address of nearest liuing Relatiue, ~ ~ , was he an efficient man, ~ . Was he temperate, Where and in whose charge left, {JI-~ ~ Name of Physician called, if any, v'Cj? #, l e ?<~- ~ - ·----r, ' Name and P. O. Adress of Witnesses. Nature and extent of Accident, Cause, ~~ ~ ~ -??-~ » - _:,,,,/ ~ i f- •-'-1 a~~ ~ ~-c- ~ ~ ~ , I ~ --L ~ ~ ~ ,,:c;; ~ -?-C--C ~ ~. (Signature) Date C-7-15-03--011. 1 ~-~ Title, ,>n_, ..--',,., ~ 1 �STATEMENTS OF "WITNESSES. ,,... ;• I,· ( ., . t., j: 'j f: (; ... ~ j; j,' ., ,.. _ I . . r ...,._ ....,.._. . .c .. \ ., \ .. . I ' ·- ' • . .• ·~· ." �Form 123. N PACIFIC COAL CO. raE uNro REPO!?T Mine No. ................... . OF PERSONAL INJURY. 8up'ts No. ,.; Person inJured, 0 _ _1 - i Name o1. ~ 0ccupat1on,. c!J,~ / 6 ,, 190 J-/- Time , ? ,' \JO {) ~ oate of AccidJP:J ) l . y Mine No. Entry No. '/Room No. Locatio11, ~ , : , ~ . . ,·ed ;11 A1111e, sta e where, ff not IIIJU h ...-~ :i - . PC, , · - • £. G? /J(, -3 1/- Mine8upt. ; ; I : ~ ~ Name of Mine Forman, r/c J •v/ &t:, • ~0 ~ P (, - ~ Age of Person ~njured, _ JI-~~ Married or Single What family, if any, ;-/ How long in employ, of Co., .. ~ ~ Condition of Life or Circumstances, Name and address of nearest l1u111g Relat,ue, 8 ~ ~ ~__e,_,_·f' /r:ft~~/ ~ ~ Was he an efficient man, ~ / . Wasj1e temperate, ~ . • Where and ;11 whose charge. left, ~ ~~ Name of Physician called, if any, ( • c7- - - -- ~ Nameo1 ~ 0-~ Name and P. o. Adress of Witnesses. Nature and extent of Accident, Cause, (Signature) Date 7 ~-e( �STATEMENTS OF 'W ITNESSES. J✓,:_, ,:.,.✓, , ) - ( -fr- -e- = ~ 0-r.-..(' z- ~ d,..--,.;C ~ - " r-t...-<. .=L.c " - , f/p ~A.._. - .. ' . ¼~ , ._; ,: :- --L,,,,,__.~·~1 JJ • -:7-.,,_...,•.._;F-t-.,:, - ~.-< •,_,_,,.~ • ~-~-- I • I C-____,_,.._,.__1 41 ✓~{,, _,,../.,_,_,__,✓ ~ 1 ,.?.,...,,-. ~ r/'- A • ~ -- ,._,__Ve,_._ ~ L. ~ 4 j....,__ I -c..-.,-~ l I I I I I I l I I I I ,, l ll 1. y-/..;e .✓,L _../~ .. e/ - d -~ ~ ,.... �Fonn 123. TBE UNION PACIFIC COAL CO. - - - ~ - Mine No. ................................. >ORT OF PBRSONAL INJURY. REI \ 8up'ts No . • •••••••••••••••••··········· me of Person injured, O_:_ r Na occupation, ~~ oatc of Accident,) cP ~ oZ.... 7 ,,, ~ ,4 .,. / ~~ 190 ,f- Time Mine No. / Entry No. Location, _t-~lf' ,,.>-:-// ,<,-->-- f_,.,,..., If not injured 111 M111r, state where, , ,,. Room No. Gl{ /~~ . ,; ~ {/ _/ Name of t,fme ~u~Jt: ---~ •;--· , CL:l-c..--~ Age of Person ll1JUI ed, •:I · ;,-_ct--~ CL, Al, ' Name of Mine Forman, , ~ Married or Single q, What Family, if a11y, - /. How long in employ, of Oo.' 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'"t· ·· (J· l_}' I • - I I n ( I ) -·•L RO k springD u,o Feby 23rd, 1904 we, the Jury duly empanel a nnd a,"!orn according tto Le~ by ltike J D&nkonlti, co oner 1n and for !!; ,cot water County, Sta.to of "f'yoming to i nveetigat e intothe ca.rise or t h t h e b ody o.nd. place oi' d c c.t h of onci, u To.yo, after vi ewing acc ident and hearing tho testimony of uitnesses do f1n4 t ha t the said ll To.ye came to hia death about 9 A.1,: . :Feby 19th, l 1904 a t the W7oming state noepi t~l from shock due to i n jurieo received by a. :fe.11 of rock Feby 18t h, 1904 in Rco!!l 119 Entry n o 1 Dip/ No 7 lline of the Union Pacific Coo.l company of Rook Springo \-;yo., o v;e fv.rther find t ho.t t ho deceased c~me to his deo.th through c o.r el csnn cso on hie ovrn pa.rt. ( Sgd} Gco.w. AOO JOh.Yl Pena ick n oses E Harvey Pres ented to me this 23ra. do.y of :Feby A.D. 1904 i n t he to,m of Rock spring• , wyo. (Sg d) Mike J DankoTio~i? Coroner . . . . . J '..'IL'-.1L•.P (i' l: . . -~- ... .. u. ~,11~ Li!1.,; in tl~u c rO:L, 0\.-,t ,.i~--:r i. • r ;r. �----... :~ l!'orm 12.'l. Mine No. 8up'ts No. Name o, atioll, c5f_~ Location, / ~ (f~( oate 'I I ,r ~"" occt1P0 , Accide~\ 7_ /i, 1 / ~ 790 Mine No. . Mine, state where, • • red /II If not 1111u /1//J/ : • Age 'J . 1f any, -....:,,. 0 ? c- • • "7 ••••••••••••••·········· Time 7 /:Lo'~ Entry No. / 7-[loom No. I / /l Name of Mine Forman,. ~ v / If ✓, A)· / ~ Married or Single ~ a / ---f7./ ~c.. c.2- . . - . 1 J4 L r111eSupt. ,,,_J-C-V , ,;z!, {C£2-·,.-Q;.-<-?r - ·•ame of fr 011/flJUJC., • • •d /1 0 1 Pers J6 -----7~~ 7Jf, , .,,,,; · ·ured, !1., , ,; person rnJ ~ I ' I 1 1 • , ,F co., 6 -~ ,.-( 7.,, _ _ ,,,,...~ Condition nf L~'fe a, Circumstances, _ ~ in employ, o, . ~/ _/ .I! ~/ HoLU tong ddress of nearest living Relat1ue, ~ ,G7 - ~ / 'f ~ ~ - e / , ~ nd Name a ae,.ffia,en • t ma,i ' / Z,. ;,,.,,- )-,.,,"1~ Was he templrate, - r. -., -~ , /p ~, 1/i t,e an 'Jl' qL.. I as din whose charge left, ,. ~~ VJ/Jere an . ·an called, if any, ~ ?, .,,« .-'l-_....e---,:- q ~ c:l-.a~, What famil!f, b Name of p11ys1c1 Name and P• O• Adress of Witnesses. l e I' \ (Signature) Date 7 �STATEMliN'l'S OF \VITNESSES. �1.-1nr1n 12:J. TIIE UNfO RRPORT N PAClFIC COAL CO. -- - OF PERSONAL INJURY. {;;L l?'l -~ , ; ..,,V ,, 0acupat1on, "dent oate of Acc, L...L. Time , /-.,,.,..--..--/.tfl ✓/ c-2... /?"t..--~ 190 -y--'f -_7 , . ,z;~---/c_,,,,-,,.. - 7 ~111e No. / ~,) . I? -· c / k Locat1011, I ~ . 11J•ured in Minr, state 1 1ere, If 110t II Mine Supt. /<-~,. flame o1 ' 9 Age of Person injured, _- • What Family, if any, How long in employ, of Oo. w~ / r ~,;'~ / \ _, ~._,,.- Entry No. .:J Room No. g 1~~----,,,J . Marned or 111gle ? , ~, c;7'_;__ - - ~ ~ , , , t _ f , Name of Physician called, if any, . ~. - ~ _f}____/__ Condition of Life or Circumstr nca es,-:- Name and address of nearest liuing Relatiue, Was he an efficient man, ~.........,..,,_~Where and in whose charge left, R ->?/. ,.:2.. ,,,, :--c.-/,~ ----~ Name of Mine Forman, . . - ~ - / I 8up'ts No .................................. . ~/,,. 1 ) '~._.,,.., z-L,/1/ (2 ,-1 L ,_& rso11 injured, Name o1 Pe ) . Was he tempe ate, . ;y;:-.-:v~-~ ~~ N--==t...--7 -,-. P 1/ ~ ~ A~~~~-.::.--c...--r.....-1 Name and P. o. Adress of Witnesses. Gause, Jf. 0£~ ,J (Signature) Date 0-1-m.o:i. . uu. 1 A7 >-' Mine No. •··•·········••···•••••••••••·• .. Title, >-1-7:,y c7 r ,L ,,,,___~,,,/ I �STATEMENTS OF WITNESSES. �i; UN 'J'Jl ro.N PACI - J?IWoNT l'orm 123. FIC COAL CO. 68 _• ONAL INJURY. Mine No. ............................... ~.. OF pE,'RS 8up'ts No.................................... if Person ,·111J·ured, , Name o . //)~ /J . C:Z,/ -a./---C occupat1on, . ) --; 790 Yof Accidcnt, , Mine No. / oato " I r't--· r ; ,.//.,,_"",_,. Location, 1/ Mint', sta e where, • ,iurod ft1 I/ not mJ 'J , ,.. f~ Time Z. ~ / Mine Su/Jt, Nameofof "Person • IJ·ured,,. Ill at .,., -~ ~'J~ d ,{I~ ~ · -4..,, y' , _ ; .. / Entry No. Room No. Name of Mine Forman, Married or Single ~~ ;:,t Family, if any, • ,; Condition of Life or flircumsta'!J)eB, , . • employ, ofOo., Al CA! ,...,() -£,.. _ . , d ~ ; , Z--~L Ho• long m 1/ ,..,,_,_,,, 'r-'-<- / · f O,f earest fiuillg llelatiue, Nam• and address n ~ ~ ~ Was he tem erate, he an efficient man, L_ /2£,_«--: - p- was d in whose charge left, / an • any, Whereof • ·an called, if Name p11ys1a1 C, ✓, Y. , f\ , ~~ .., ,... er ...-z....-.,; Name and P. 0• Adress of Witnesses. Nature an Cause, Date d extent of Accident, 1,1-/ C~ ~ ~ -c... ,;....,,,,i__-, ~ , ,/ ---Lr �R~pON 70 F orro 123. roN PACIFIC COAL co. tIIE UN - Mine No. ...............................~ T OF PBRSONAL INJURY. 8up'tB No . • ······················-·········· ~ ..,/~ - - ~ , _~ _; ./ G ,,, of Persall injured, 1iov::::1ation, ~ oate of Aecident, JJ , Location, ~..,,,f .4:;fo-,,.--.-n--r----. tiui·ed in Mme, stat/w here, If not 111., , Cf.? 190 If- Mine No. Time / /4_,,✓ L a;~-4 , Name of Mine Forman, ,,,,-Y-.....-z ll ,,., , ·--;,·, -/-' ¢'!',/.a,.__.-;/-:7a.L-<?~ v Name 01 Mine Supt. Age of Person injured, ·l /' = -i:.--,:., __..,--; Married or Single ~ n-q-er t/ What Family, if any, / HoUJ long in employ, of Co., d2:?'Lf .-n,,,._...-o, #- / ½ Condition of Lif e or Circumstances, _ Name and address of nearest /iuing lle/atiue, /f---'--4J ~ ' . . _ , . Was he an ejjioient man, r-e__..,z_/ Was he temperate, ~/ Where and In whose charg~ left, ./7--c-e--- / , < " -.. - ~ , Name of Physioia11 oallod, if any, {?, ./?C=-··.,, , ~ Q._,,_,;; :,.,_/ ~ - y~ ,;jd,._,-f 4 I ,-./. • 7 Name and P. O. Adress of Witnesses. Nature and extent of Accident, ~ -~..--?~ ~ _ , ; f l ~ ~ ~ - - ~ , t:7 ~~ ~ ~ ~ Cause, (Signature) Date 1 C-7-tG.03-.011. J-i,.-0. Title, ;C ~~ /7(, cft. ~ · 7. ,, I �STATEMENTS OF WITNE SSES. I I~ I ' I I I �STATEMEN'fS OF \VITNESSES. h f ~ .il, ,, I ; I /., . ,. ; .' f • . Q ,I I �STATEMEN'fS OF \VITNE SSES. ~ ) A'. I." I . , ... . • r-- ..1 . . 1· ..,. .. ' l I . •. ., .. t ,.... ... ...-. .... l,• , l j .. t, . • .., .. ., ( p f .... ru: i, ' ,.., I • 1d T' hV ,'I . .... . .. • �Form 123. ~ UNION PACIFIC COAL CO. fflP F PERSONAL INJURY. p1woNT o ·············••.-··- 8up'ts No. ••. • ········•·················-- ,I Person injured, . 11amc o; .]1 ,I Mine No. , /r~ '7 ? 1 ~ occupatio11, • +~~ ~ -1/to of Accident, oa . ;vI ;;;---~ ,,,-;. -r-r->--~ Loca t,011, , . . . d ; Mine, state w11ere, If not mJUI e 11 of Mine Supt. 1 ; ; : : / Person ~njured, 790 ~ Time Mine No. / P-~,~~Entry No. ;;i.... :?---.. Room No. - ~ -~- / 4.:f..,,....... ~ ~ / l a m e of Mine Forman, (}~__,__, _,,,.. 7- ~ Married od:¢, ~-f What Family, if any, .. . /on in employ, of Oo., t' ~ ~ ~ O o n d 1 t 1 oofn life or Circumstances, How g address of nearest 1·wmg • R I t· e a we, . d Name an rZ/ __,_, Was he an efficient man, /-..1--0 Was he temperate, Where and in whose charge left, {/;}, (E, /~-n--:>.Yt.--??..-i._v-r.--✓, Name of Physician called, if any, (3.. /</- - ,7 _ ,,,~~ ? ~ ~1 - c;. Name and P. o. Adress of Witnesses. ~ ~~ Nature and extent of Accident, ~ , 0 ( J J {!,/(1 I Oause, (Signature) Date C-7-IC.-03.. 011. 1 ~ ~ Title, ~ cfi~ �STATEMENTS OF \VITNESSES. �72 Form 123. TBE uNTON PACIFIC COAL CO. Mine No. .....................................( RBPORT OF PERSONAL INJURY. 8up'ts No..................................... Name of Person injured, - ~ occupation, ~ oate ~f A c o i d e n ~ r ; - : : ; : ~ Locat1011, --:~--:,_- - _ / If not injured in Minr, state where, Name of Mine ~u~t. } Age of Person 1111ure , -~ ~ ... i 190 'j Time Mine No. / If- o ,--t-.r:,4 ~ Entry No. & >1, Room NI/ • + J. J7;.~ r9' tt a.-d...~ ~ N a m e of Mine Form~n, Married or Single r ~ ~ /. What Family, if any, How long in employ, of Oo., ~ ~~ Name and address of nearest living Relative, was he an efficient man, Where and in whose charge left, Name of Physician called, if any, ~cl Oondition of life or Oircumstances, - Was he temperate, ff. .,<'.S) 0 , ~ (7 7 I Name and P. O. Adress of Witnesses. Nature and extent of Acoident, Oause, I( (Signature) Date C-7-15-03-·0II. 1 J -»{, c3f ~ Title, /?J, c;rt, �STATEMENTS OF WITNESSES. �,T c ,rfJp tJN[O.1.~ 1 I~orm 123. p ACJFIC COAL CO. ~ . OF PERSONAL INJURY. Mine No. •••••••••••••••••••······· J?/SpONT 8up'ts No. ~ ..-c:L, J3 - ········------ ••••••••••••••••······· • { person i11jured, , ~,....,,,_,v./ //ame O . '77f,~_,/ . ~ -<-occupat1on, 1...,_:,4 - - ., _ / ,,:R ,1 Accident, / /~ - - - ; _'It./ ~ ~ ~ 190 ~ Time 21" 0 , /) • L oate 0'J r.) t.-4~ ~ . -c:.--C.--t->-C.-'""' a---;??,( atioll, ~--.....r. _ / Mme No. / Entr No ;,t- 2.-? • • Loe .. red ill Mirlf', state where, y • ' f • Room No. ~~ 11 tf 11ot 1111 "me of Mine Supt.) ~ -0 ,; f >f-e-~ . • _,-~~ N Age of Person ~n1ur ' ' ame of Mine Forman C - -- - I • C7I}_ /7/ ,..,- ~ I ' ./ / Married or Single I , : : // - What family, if a11y, How tong in employ, of Co.' -5',?? [ - - ~ ~ a - - Condition of life or Circumstances Name and address of nearest liuing Relatiue, c:::5f~ , an ellicient man, ~ ., ...___...'--<---?-o...-i.-..c:;,....<..--(._.e_---.-:?C,_ _~ Was I1e 'J.J' AI , Was he temperate, ~.-:,_,/ Where and in whose charge. left, ~~ ~ ::....~ /c;c - ~ 1/, Name of p11ysioian called, if any, v o<:22-v. / -Z -; :_ ,.-9, /Y, ~~ Name and P. O. Adress of Witnesses. - ~~ Nature and extent of Accident, l (Signature) Date ;. /Jf' Title, 1 o4 -,_,,(_~ ~ C7~ �Form 123. ~ PACIFIC COAL CO. err.- t1~roN 'f,:.a.D - • Mine No. .................................... -- - r.'RSONAL INJURY. NT OF Po N11PO 8up'ts No........ ' .1 person injured, ~ k 7Uvk 6L 1~ Nameo,_ v~ occuµat,011, b oate of Accij"t, [7c_ Cf ~~ Loc•ti~n,. ".:f.te where, ¾:;n,, If not 11uure \J' ~ /3 790 Mine No. Lj Time / 8~ p9u_ Entry No,0~ Room No. - ~ t,fine Supt. (Yl. Name of Mine Forman, Name O1 ' . . 2. L U fl . . or 8111gle . / 1 ,1 Perso11 11uured, ) _ ~ Marned ~~ 1 Agc o, . ~ 1%-i~ I 4. ~ • ~ What Family, if any, /J /J ' J,v..,,. I) 4 ~ . ~Lr-..._p ~ c....eA..<2_.:) H tong in employ, of Co. w-uAJC 1J-u.,,1',- a-:i v~cL Oond1t1on of Lilf Oircllmstanoes, fi. or N::e alld address of 11earest /iuing Re/atiue, ~ µ~ a., ~ ,J Was he an effioie11t man, ~ Where and in whose ohar,Jlleft, Nameof Physician called, if Y, y J o/;J"" £ r~~ J IIOL-<~A..A..-4--...._,............._.,,, Name and p, o. Adress of Witnesses. Nature and extent of Aooident, '(J ~ (Signature) Date C-1. 1:;-03..6n. 1 Title, _J_,-4_,,u., ~ ,; 1 , . J ~~ G- ~ \._r:/ ~V ~ Was he - t l ,rr~att;,e,--;;z;, n7,;~ -_;;-£./4 /' ){t--wf'J • U- I I �STATEMENTS OF 'WITNE SSES. (' I I 'P - ' ., ."( •I I! llt , • ' • o... , ., . • l tl., • ti ' 1,' • ... • ,,.~, .. ,..,r , .t ... n l .. J· .. . �STATEMENTS OI" 'WITNRSSES. J. lt ,.: ;ut a 1 n • l r lit \ 11 •f: ,..r,, •• • , !:. r ~?l l:lll i;d 1 •• f l l r.•l : ·; d . tht: ... ot •. 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'I' I I . r,. nut: t: 1it al �II we the Jury dulY eirwaneled and sworn according t o law by lliko J nankowek1,Coroner in and for Sweet-~-ater count7,state of Wyoming to inveet igate the caus e of the death of one, sames Subeo. Aft er viewing the bo(tr a n d Jilace of ucci •JOnt and hearing the test1mofl1 of witness • d.o f1n4 t hat the sa1d J'aznes Subeo came to hie death avout 2:30 p .m. ,~roh 30th, 1904 11ameand p, 0 in r'OOll 38 NO 2 .Entry o~ No 10 mine of the Uni on pacific Coal comp~ny of Rock springe, Wyoming from i n juriet reoeive4 by a f all of rock in above aa1d room. . //ature and ex; Ye further f ind the above to be accidental. Carl Brown Adam Barrai, Alex s ftetoher Pr esent ed to me t hia 31st day of M&rch AoDo 1904, in the tomi of Rook Springe Wyoming. (Sgd) Mlke J Dank0WFJk1, Cause, Coroner. JL ,. 7- ~ AA.,r ~ {,. I I �Form 123. Mine No. ..... . 8up'ts No....... .1 Person injured pame o, 0ccupatiOII, <J,i,,,, ~ te of Accidp~t, I ;L.-:t.:o-.,,,., ' oa . 11 (If~/,( 19-'. tAr 1 Locat ~ •. d in Minr, ate wher , If 11ot 1111ure 790 // Mine No. Time 1'1J Entry No. ~ ................. ..... 75 ~ •• ···················-··· Room No. J. ~¢ /'/'(Pa_ /,fine Supy:.tAJ//.ifo.. e ,,; ( Name of Mine Forman J-J_ Name 01 . . :? /-/ .' ~ l.J..,,CAJ °'--'<._ Ae of Person 111} IY d, -I -,{ ~ /J ,, ~rned r ingle 1!,at family, if any, 7r>-C<-- ~ • e • /0 ~~ ~ --r-(~ ~~ ) How tong in employ, of (Jo. Oond1t1on of Life or (Jircumstances, ddress of nearest /,umg Relat,ue, ' , Namea11 d a Was he temperate, Was he an effioient man, l'/here and in whose charge I , I ~ ~ d • ~---- Name of Physioian called, if any, l1e Name and p, o. Adress of Witnesses. Nature and extent of Accident, (Signature) ~ o"' �STATEMEN'fS OF \VITNESSES. ~ -e (. {. 9 l , v-£t,, tJ /:J. ~ ,;2 h l:t,<_ , -tu /l-'i/4 r'";~, JI-<,; ' 'I .i.tt -«-;t t4{ iI .,.,-[ I . ) ~ ! i· " I ~ ~ �'l'Il 8 s u~noN - ,spoRT li'orm 12.1. p.ACIFIC COAL CO. 76 / -- - Mine No........................................- OF PERSONAL INJURY. ~~ ~ ,I Person injure~,o j Nameo; occupation, di ... '" ,1Accident, ; t ~ : 2 ~~~ . (!;.<..,,<..-<..-,< ..-<-<. t:L ~ Lnoat1011, . • lftd in Mine, state where, If not 111)1 h (;, . 190 '--./ / MmeNo. J.:a 92e'- d. t_ u.. ~ Mine Supt. ,; Person in· 1re< , O Ncm1c of 8up'ts No. O <f p ~ Time / Entry No. j ame of Mine Forman, / ~i:6:., JU ~ Single I 9 Marrie What fam~ly, nJY, ~ d._ HoLU tong 111 employ, of O ·' '7 ~ Name and address of nearest liuing Reluti6'e, ~ Oo11d1tion of l.ife or Circumstances Agc 'J . , - 1 was he n11 efficient man, Where and in whose charge left, '-Jd--1, O(J~- Name and p, o. Adress of Witnesses. ( Nature a11d exte11t of Accident, . .. ~( ~ cfz.JO Nameof P/lgsicia11 called, if a11y( -:1 J <).-e:(..<--<... v(._..,, o • Was he temperate, ; J o-~-<._ C.. ,t1- ~ ~ -• ? ._ 17 tro... u ~ fcJ~ , ._,..,: 1 C-7•1:i-03. ·UII, ...__,_-<-<'--C...>-e..--<....:~ L _ Al~r //'\___ d _, (Signature) Date ("l u Room No. Title, �STATEMENTS OF 'WITNESSES. II I I �P . O~ PACIFIC COAL CO. ,-fl£ o~r J.. - - Nfil'OR 8up'ts No.................................... ., p.,son injured, 11~ ~ Namoo,_ ~ ·~ i occlfl)atJOII, 7n ~ I~ ,; Accident, oatc ~' ./J b'?/f'< ,J,,li- '-z,/4.<...,<--j : : , I 1 . l ocation, . . . din Min<', stat w11e1 a, 790 Mine No. Y Time S- Lrz..., Entr y No. / Room !lo. c_f? If 11ot 111)111 c ~/4 Ci2 °J. :2 I !,fine Supt . Namo of , . . , Age of Person ~1111 18 7, Name of Mine Forman .n J... 1 1/~ ~~I-' CL<J fi.1amed or Smgle • -e._z_ ., _ __ JO - - * · ~ U What family, if a, Y, ~ /) _ ,,1 a.,v.J .. IOllg in employ, of 0o. • ~ r- ,,2 r;/L 0ondition of Life or 0ircumstances, How d address of nearest liuing Relatiue, ~ ~~ J Name an u/ J '2:o-c..,.,;{ Was he an efficient man, ~ Was he ~emperate, Where and in whose charge left, ~(J) )~-r-, _/J__ '- ( a_/6 /lame and p, o. Adress of Witnesses. Nature and extent of Aooident, v<-<...;f--7 ~ U ~ ~ ~ i._~J"' ~ /c::,_,,1- -i, ./J' ~ ) 1,-,_,_ucJ"71 .b'j Name of Physician oalled, if any, r?}.i!<- L 0-, ,:__ ~ - ~~ ~ c/.Jc a..1:.-,} . ) 7 ,,,( I l - I (Signature) Date 1 C.7-1r,-ro..u11. j Mine No. .. ........ ...... ..... -- • ,r.-RSONAL INJURY. T OF PLJ \: Title, o(_ , , �lJ'Ol'ln 12.1. pACfFIC COAL CO. rus oKION__ Mine No. OF pBRSONAL INJURY. R,;poRT 78 ········································~ 8up'ts No...·················-·· /l d (/ fl ·······--···· o' person injured,~ . ~ '( 11ame" .£ - . e 9;;-~ U~~ occupation, 'dnR~f,9/-(~Cc./ ~ 790 L./ Time of Acc1 -, , I / oate . C'i :,--e- I{ ,<.v,7.,2/'"?..--'--'<-<-oo Mine No. q,Entry No. Locat1on, / .. ·ed in Mine, state w ere, If not ul}U' ~ r ., Mi11C supt> O t'\ Name o1 . . Ld, 5:y3.l"-<-./( 4t) Name of Mine Forman , 7 (' Room No. /J l)r ..,J..C'-L.L--C...:z--u-c- Age of Person ~111uu; ' .____ Marfed o; Single .d-c...,~ What family, if any, -. /J . /. I ... .. . . L/ H tong in employ, of (Jo. , ~ 6 ~ Oond1t1011 of Life or (Jircumstances ow and address of nearest liuing Relatiue, U .;,? .,,,.,_ / Name / ~ -....-.. Was he an ejjioient man, CZJ-.tz-o Where and in whose charge. left} Name of Physician called, if any, Name and p, *'"'_, _,,~- ' Was h ~ ~ ) ~-L&<....L (}. 0 71 ~ ~ o. Adress of Witness~ NalureandexlentofAccident, emperate, I I l i '),;Ma.-/fl,..,.,,., d..,z____, Uft-~ ~ ff ~~I (Signature) Date 7 Title, �tIIE UN [ON PACI FIC COAL CO. Mine ORT OF PERSON AL INJURY. J?EI' \ 8up'ts No. ••••••••••••••••••········ ~ )/h,~ oacupatio11, 7 t' ~ Q oate of Aacid{e t, 'J ~ Locat1011, • / tn--· '1~ ~~ ff not injured in f/linr, stat where, ~ 190 f Mine No. / Time Entry No. ~ !lame of Mine Supt. /.d-e.. Name of flline Forman, Age of Person inji{il, ~ What Family, if any, _... /J I q How long in employ, of ( J o . ' ~ <() t1j_.,e_ °'--L4 Condition of life or Gircumstances, Name and address of nearest living Relative, 0 ~ ~ n A - A ~ 1 ~ 0 _, was he an efficient man, ~ / ~~-;;;i(jmperate, Where and in whose charge leftO ~ ~ ) ~ ; ~~ Name of Physician called, if any, ~ b ' - - { J - ~ ~ - - .__ • Name and p, o. Adress of Witnesses. Nature and extent of Accident, Room No. ~0 1 ' • 5.--4 {/ ~ �STATEMENTS OF ·w1TNESSES. IJ , , I lj II I I·! �Form 123. ,1roN PACIFIC COAL co. -ras u ·" 80 __ _ Mine No. ·····························•· ......~ , PERSONAL INJURY. . REPORT OF 8up'ts No. ······--·············· W' ~ ••••••••••··· .,person ;(/,red, CjPlu L,v..-- Name o1 occupcrtion~trr)-V)1Z~ i tJ ate c,f Acc1 1 J _ O . l' ~/V'-L--t.--<..r LoCtil/On, , .I. . . red in Min", state tulp:re, If not tnJU y;' , W ~/4 rnoU 1 !Aine No. Time 0C> ///ov Entry No. o......~ cJ Room No. -< ~ ~ [ _(c _' Name of !fine Su~u! "'- ~ , ( Name of Mine Forman, Jt' Age of person in~ ' 1 Married or Single What family, if Y, /J JJ / .... / Jong in employ, of Oo.,u,,,iru-u--- I IJ /J.n,,-n t £/<-✓Condition of life or Oir~um . . R . ~ ances, HoW 0 d address of nearest /,umg e1at,ue, ),,, p- ~ ·; Name an Oc!,__-/-< Was he an efficient man, ~ Was he temperate, Where and ;11 whose charge left, -Yv-';:f-v ~ ) ~ e,, / ~ ~ 7::::: , tr ~ Name of p11ysioia11 called, if any, U O ~ c_&_ ~J~ ~J. -Lt Jf~~ Ham• and p, o. Adress of Witnesses. / 'J, l e----..--- ~'--<-<-- /4.. d!.-fJ,,_ c-/4... "(_ / Nature and extent of Accident, Cause, '. (Signature) 1 Title, �S1'~\TEMEN'£S OF WITNESSE S. �Mine No. ... •• •·······•••••••••••······· 8up'ts No...••••••••••••·· •••••···. /Jame and p, o. Adress of !'fitnesses. Nature and extent of Accident, (Signature) Date 1 Title, -~ •••••••·• �:r: o.· .. •ii.'!.? T :· h~ o.•:ior a c f t. c, . .i1~ , !:c .. . ,,a- ~n :,,a; t, T1,n; :i.r, 1,1 .. ,. 11 1./ • . ~ . ' . .,.l v , , ,_.,, tk,J1 :i r ,:l" •• - ~ lor.1.J: :!:,::.;;_ l ... ·'- ,. ry : ... t ~l.L C!i. ,, t-Y Lh:. l.:.i.n,.;;'I ~ ~: ~-~ iT... l ~-~- t •·, ,_,,.:t;~cr . I -~1 ~1nk hu ~-;.n 1 !ad :j v _, .·t.n .....-G ~ ' . • , , . •tn . · • n ::.11 , • ,.. i 1' rt') 11 ~1· ... t roo?.t , \,' ··• . l t: , 0:1,.. (. t, . l }U. \~(, ,,. CA ... .t· ~ .' , / 1., 1 I •·,o, I c'• ·., -d :~·;.;, r-L11:" f:r1T.'1 " i•1 j vft !1,, uay ·01'orc 1~0 \J0.8 h ,.r t . 1- h • -~.n : t.:1. .. l CL , c i ,t,,n \ , , ~c,.,, hi ,o '.., ,1, u nc. 1, • t:!ink 11u rn...o u.<Jin,. 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Union P .. cif ic Co tLl c0my,.JlY of ~,_o ck S1Jrine s \TTyoming • ( Acciden-. 0ccur.i:~d t.bc;u t 1 :. : .>0 !: . m ... ,.~ •.:"ch ,J(fth, 1 9 0 • ) ...a furth . r find t h 1.. ;,.b o•rt..: l o b u ...cci o.unt o.l • f/otur 1•0 ci1. v:ro.l t d re A •,.. • nava.la • _J ..s•.... .;.: ~!~ ! ti u [j,... .:, . .... �89 Form 12.1. THE UNION PACIFIC coAL co. Mine No.··································-····· - -·-· - AL INJURY, REPORT OF PERSON 8up'ts No ......................•••·······.... Name of Person injured, .... Occupation, )?'2.-v~ ;J f () Date of Aceidant, J~~ (!....,,{,,,LLocation, (Rc-c,,,H ~(/(.../4-r If not injured i11 Mine, stafe where, Name of Mine Supt. I: o o 7901/ Time Mine No. / Entry No. Q 'cl~./ Name of Mine Forman, 1/ &~'i Room No. ..-H~ ~ 2 - 0 Age of Person injyr_;,rB3, Marned or ~ t:Jle J7 l ~ d... What Family, if My, How long in employ, of . , ....P ~ ~ Cond! tion, of life or Circu ances, ~ • Name and address of nearest living {!jlatiue, ~ ) ~ Was he an efficfent man, ~ , , Was he temprfG.ti ~~,e_~ Where and in whose charg~ lefJ/ ~ ~ )~~ Name of Physician called, if any, ~ ~ /r¥G yq Name and P. 0. Adress of Witne~ses. �STATEMEN'l'S OF \VITNESSES. �83 Form 123. THE UNION PACIFIC COAL CO. - - M. me No. ..............................•••••••···.,,,- AL INJURY, REPONT OF PERSON . 8up't8 No..................................... Name of Person injured,_ "----"'~ Ll- {lh,..v<.dOooupatio11, 41/2 oate of Aaaident, Looation, .fl:.,,(...,L.-<- I ~ d L.f 190 ; Mine No. c;,....-v<- o<__, Time f2 Entry No. If not injured in Mine, state where, Name of Mine Bupt.,L-<.-t.,o 7 !Jl_,_( JC<A..,<..,LName of Mine Forman, ) Name and address of nearest liuing Relative, ~ Where and in whose charge I(!/ ~ ~ 1: Name of Physician called, If any, • ...-<..,/ •- Ju I--/gJ__fJ"-"---. Married or f!f <Jn~ 1e Condition of Life or Oiroumstanoes, @~ ~....... Was he<iemperate, ~ Yh e i!u'LrL-< C'-f c( (Signature) Date 7 Title, &Z ) ~ ~ c>(__ ~ U ,~(/ Name and P. o. Adress of Witn sse • p . , _ _ C-1-1u-oa. . ou. Room No. . Age of Pers .• 1JUred, _ Q What Fa r1ily, if any, t~,,A,...~ ( <3 .-ff How Jong • employ, of Co., {p rvn--v-z-.---l ~ Was he an efficient man, f' S d a_,.,__,,{_ 7 I ~ . • • ;I �STATEMHNTS OF WITNESSES. ,.,11 . en:1, H •' ~. /4M ( r,(v h ..,_ l I ./ i I ,...-r~ \ �- Form 123. §4 UNION PACIFIC COAL CO. f r-.IE RTSPOR - - - · T OF PERSONAL INJURY. •••••••••······ 8up'ts No .................................... n' ~ icn· ., person injured:, Nam••, Mine No, . ... / . . .. % a t , o-vu z,~ occupation, L ) oate of Acoident ~ - /J f-. /J cf_ , ~~ i.....X ~ Locat/011, ·'. ·ured ;11 f/iinP, tate where, If not 111} Mine Supt, _-;;;;~ Name 01 Age of PersonAnjure , What Fa1~/y, if ~ny, !J C Mine No. y Time Entry No. ~ I r p <)/l ,,(_ j,2 ; 1 ~ ~ ~ N a m e of Mine Forman /"\ I} r - /) b ~ll4Jondition of life or Circumstances, nd address of nearest ·uing Relative, Name a Was he an efficient man, Where and in ~l~ose char.~ 1/ t, ~ Name of Phys1C1an call ' if any, ~~ _,_,,L/l~u .,,-,, ·,.-.~- - ( ~&<.. _ _ •. • U , q__ A' ) /J f} • rv t?"t- l4--( w[ aA..-<. ~ ~as he temperate~ )...,, __,-;:,.._,,,,, .-r...-~ ~~ 7 U_) -'I ;!:f--~ Name and P. O. Adress of Witnesses. C: _Ji XL .. ,..__,_ -~ /1 U ~ 0-Ztrju- ~~ ~ G}.A- L u .J ~ ~~ Married r mgle _ Room No, '--( .J j I 1 H w /ong'0_J!}JPloy, of Oo. ()i,(r~ 0 790 a_,__,_ o( I \ ; .1 £,,,trkJ "'" c(_ ..-/0-<., J_,/ ~~ ~ I I (Signature) Date 1 C•7•Ui-O!l . .nn Title, �STATEMENTS OF \VJTNESSES, \ ( .,,. �Ill li'orm 1~. gB o.NION 'l' PACIFIC COAL CO. --- ----- pEPOR Mine No. ··················· ···· · · ~ " r OF PERSONAL INJURY. 8up'ts No......................····~-- (;"- ~ ., person injured, ,A/2A-?,u~ Name OJ. tYh .-: . I. ~ J (/{.R_;r ~ occ11pat1011,7 1 ~ .1 Ar(d";.lt, Jl(t}o--,,-e----"U-_ 790 .L/ Time / /oo /J ~ oate 01. fl. I /'..-., ~f~ YvVU Mme No. 1' Entry No. ,l) ~ Room No. Locatton, v -· .. ,re(in Mine, state whe;,1:'7 If not mp '(}, i;J l %! . L& Name of Mine Forman, ~ { , ~ Name 01 Mine Stipt.v Married or Single ~ ~ ·oZ Age of Person in· II' , 1/ (, , What family, if Y, &,· ~~ How long in employ, of Oo. ' ~ I 6 1rY° Condition of Life or Oircumstances Name and address of nearest living Relative, U• ~ ~ ~ ~ ~ ,g~/4 IE: was he an efficient man' Where and in whose charf}i I. ft, Name of Physician called, • any, >? ' _ 1 Was he te,Uer;te, '/~ ~ I i Name and p, O. Adress of Witnesses. v:::- Nature and extent of Accident, ~~ ~ V cl- /4c.,_ol.__ (_ (Signature) Date 7 Title, �STATEMENTS OF WITNESSES. L (' �p Form 123. ACIFIC COAL CO. HE CTNI01N P 'f - - -· J?EPOR c.-87 M. 1ne No. ........................................ T OF PERSONAL INJURY. 8up'ts No......................·············V°' ,.; Person Name 01 trrfered, occupatio11,a, nt oate of Acc, [ ci:J 'lA..,,L /'">--a_)~_.,,.- ~ ,. O 1 /~ ~ - _ ,;,; '- e_. • p I i p!)..-_ '/J-"-l.,.-vv(. 0 790 Mine No. --::) Location, Ct elµ_ ·,ired in Minr, state where, . fF /10 t Ill} .,.-:, J ,,,., ~ ', {_ , ) e, Name of Mine Su'.Jt-,,__{~'- t>o------/~ c;__.c--/<.. Age of Perso11 ip111~ed, f Time q-, 9/ 'J t) a Entry No. 0 fl.lame of Mine Forman I 2 I " / ', M t/h~4 t_ _,4_L.,.,(.,.._.-cl_./ ,, ~f (J / aondition of Life or Oircumstanoes, 97? CL JJ . I} f?_.8----C.(?_-<----<--..J.- - { l ) ,,n:::-/_;,.._,.,0{).,.n ,,~ t-£-< ff:::> Name of Physician called, if any, UU Was he t emperate, '-:JJ-v~ro [ :z-.Jl..J ( o..J f ----.( J,?_ <- .._ / ~ Name and p, o. Adress of Wit[lesses. ~e., C)1,i. CL ~ er~ NatureandexientofAccide11t, / Married or Single How long in employ, of (Jo.' Y, i • 0 ( d address of nearest liuingf~:rrJ.e, a/I -:;::, Where and in whose charge left(} Room No. J} / "' l7 r-C-// ,.., , - 1 What family, i(3,PY 1 Name was he an efficient man, ~ _ JI/J;jr :t,~ czr-f{r &-e-_~ L ~ ~ . /l (/ I U. • 1-~ ~ ~ ~ c{_ t _ , _ ~ ~ ~c(_ ~ o.i,a,,, (Signature) Date 7 C-7-t5-&.l--on Title, �STATEMENTS OF WITNESSES • .,. ' ? .. iii. ~ . .,. \.;. ~ ~ "" \ I. �STATEMENTS OF \VJTNESSES, ,,. t-~ ~I i-D 1/' Gd Ai ,1 I ', "'i I I I # \ ... ~ .. I!.\ ~ .... ,.. ,.. I", (\ :"I. ' ~ ~ -;.I �Form 12:1. PACIFIC COAL CO. rfl6 uNfON Mine No. •••••••••••••••·••······ ,r OF pERSONAI, INJURY. f<ISI'O}{ •••••·· 8up'ts No. ···················-· .. )~+fZ -trz_-~ •• d ., Person l/1JllYO , 11amc 0, C' e., u , . cJ C. 'L"--'-'- v 7ccupat1on, O.l1.....,cl ate of AccitcpJ, 9 . ftr1...-· t... ~ £v , 1 1octdiOII, . . . d in Mini', state w11ere, ff not 111JU' e 1 ~ame . .111. (... ••••••••··· 1 ~ ) ,'f t.#._.., 790 L./ I Time Mine No. I Entry No. 7~ 1 A- v v-o-; ,,, C JI ;rJ , r -znrlLu o1 t,ine Supt. C ' 8 7 / Lj c CL .(,,,J C<__.,, '- -ii,,,(_, • --R.oom No. Name of ftfine Forman , fllarried or Single t Age of Person :111 ed, ; What family, if any, ~ J,,g in employ, of Co., t.. U r, f u u.. u.., J- J 1 11 z.,,1/:/i (,, 0o11ditio11 of Lil'e or 0irc t How /0 . vJ , L' J1 ,ums ances, ddress of nearest I 11g Relatwe, / "1.. -l.. e-~t: c... a. ✓ ) ·' /J J )i ,/ Name and a ...,... O\._ 'v--z..,l{j_ tr ve y < - ~ c;_,/ ~ 1 Was he an efficient man,. ~e......-- ,j;)--,,.. (!_ Was he temperate, ~ (J Where and in whose oha1g 17t, (. / /' C<.--z.......--l--'L - z.--,--z...-v- vt. J Name of Physician called,' any, ~ ~tfl: 0 > ~v Z U Name and P. o. Adress of Witnesses. Nature and extent of Acoident, C2,; [V...., / L I, C'll Cause, (Signature) Date 1 Title, j__ �~----------------ll'o_r_ in_ l!!J-.----------■ -r:- UNI01.N 'l'l Ji~ \ PACIFIC COAL CO. - R l~PO R ■ Mine No. 9 ·········-·-------- T OF PERSONAL I NJURY. Sup'ts No. ··········--·----- er ~ .~ Person injured, ~ /7(. -/Name O" _ • 711 ~• ~ .-,c_.-,rr.A...-<>.......-t..; occupation, ~ oate of AccLJl'dt, ;71':J , // . / ,-,//r• , 4 - , , ; t . Y > ~ ~ Location, fr"" . f v r ,,,,,.,, / If not i11j11rcd i11 Mw, sf6te w h e 1 c , ~ • Name of Mi11e Supt. . 790 'T Time 9'-' .:, o o ,__,,e__.,__,.e, a Mme No J - ) ~' • Entry No. Room No. _ ~ -&--::· :z': ~ Name of Mme Forman, Age of Person ~njured, ::_I.) ~ Married or Single ./ • What family, if any, . ,tJ How /ong in employ, of Co.• Y ~ - Condition of Life or Circumstances, _ Name and address of nearest liuing Relatiue, ~ L - J - ~ _/..L-,___,~ / , / ~ Was he an efficient man, 'j,:Z~ Was he temperate, Where and in whose charge left, ft. Name of Physician called, if any, #. ~ .,_ ~ ~ q______,./ lf c:[l__ 4? Name and p, o. Adress of Witnesses. Nature and extent of Accident, /~ ~ ~~~ ~ ~ ~ ~ _,.__~ f CJ. ,,;J ..__,~ ti. - Cause, (Signature) Date 7 C-1.,r,.lXl--011. ~~ Title, O'{ ~ ~ £ ~ ~!.., I II �STATEMENTS OF WITNESSES. L yJ I 1 �rJ-JE RHI'OR 2.!- Form 123. UNfON PACIFIC COAL CO. - - Mine No. ............................ T OF PERSONAL I NJURY. Bup'ts No. ············--·-······· ,J ~ .~ Person injured, Nameo1 yJ~ ooaupation, 2 f £tz., oatc ~I AccyteJt, Locat,011, U'( ~ l l { _ , ~ ff7J •nitired in Mine, state .&here, If 110t l 'J 3/~ ti Pa/11' of Mi11e Supt.,_, z,,) /41 o.-c-1'°( 1901/' Time (; ,' {} {) a. ~ Mine No. <? Entry No.3tJ1llat..<J Room No. ---- -- ' Name of Mine Forman, t::..-¾ Married or Single ·v ~ ~ Age of Person • ur 'd, <J> 3 . r?7? ~ <-< • 6-(__ What Family, • Y, :2. C-- ~ o,l,,.._-xHow long in employ, of Oo.' / J ~ Oo ndition of life or Circumstances Name and address of nearest living Relt1.titJe,7'~ ~ ) , ' was he all efficient mall' ~ ~ . Was h Y'-~~~:-C:.:,...(..,,(.,,(__~ Where and in whose charg[!eft, ~ ~ } ~..,u( ~ Name of Physician called, if any, ~~ U Name and P. o. Adress of Witnesses. I I Nature and extent of Accident, I, '.f / ' (Signature) 7 Title, I �Form 12.1. <- THE UNION PACIFIC COAL CO. 92 Mine No......................................... REPORT OF PERSONAL INJURY. J? Name of Pe'!_on 1Jf"red, 8up'ts No ................................... . L ()-1 /-J , ~ · Occupatio11,C>(_ t:>-t:<.. ~ _ ~ Date of AccJJMY, 6 _ Location, LJr ~/2,..,,/,/l.,-(p If not injured in Mine, state ,If/Jere, a,_,,hc:e., ~/4. . , ,f ~IC~~ 0 790 fl Time 1 0 a ~ Mine No. <if Entry No. :5- Room No. J 1 q~~ ~ L& Name of Plline Forman, t/2-# ( ~ Name of Mille Su~ CA-~ Age of Person i'(iui~;{c..-, S Married or Single ,...>->-- ~ •d.What Family, 'if__g.,{y, ..____ How long in .employ, of Oo., Ooydition of Life or ()ircumstances, Name and address of nearest living Relative, ~ ~. Was he an efficient man, ~ ~ Was temperate, Where and in whose charge • t ~ , . . , f P ~ A-.L.-..-t:::i..-...,.,,,_,,,,/ Name of Physician c~f/ed, i ny, ~h{:f-f(?_. - e,,(___ Q u J I' 'IJ Name and P. 0. Adress of Witnesses. Nature and extent of Accident, R ~( oc-<-<- ,u ~ ,a;_/4 jI jl • ;1 :' l~ ~u:-c6 ~d..... ~ ~ </(_~ _"KJ.....J..ev--1----- ,,,.-/.,,-✓.A--...,-/_..,.7.,,-t---0 ~ ~ J ~ ~ ~d!-t-.J -~,~~ 0,__,,,__--,t.,~~'--t/4_., d ~ ~ ~ ~< f[r-J~~) 9 1/ (Signature) Date C-1-1a.o:i..ou. 1 Title, edLo j ~ ~ t/JA;~ G ~ ~~-- � https://haylibrary.cvlcollections.org/files/original/9db0ec9550b85dc51fe7c8683186c4bc.pdf fc04bb820e10de19d4323c33a58bb1c8 PDF Text Text 1''orm 123. .-tS[ON PACIFIC COAL CO. 'fffE V Mine No. ... ···················-- .. NBI'O!? T OF PERSONAL INJURY. Sup'ts No................................... ., pe,~0// hrjt:d, (lame o, .,./ I ~ I j }/l, zh-<- .• ,f._j Ct., L ,_:...,__,_;,,_,!'L ,,c_ 1 J occupation,~ ~/J7L _-oate cf AccJJ13Tif, l,,<//J/-z.--/ - Ll M- /4. :e, 6 - cL J 790 .fl Time I I CJ CJ Mine No. Entru No. q _ Location, .,(j_/_/ J,,'),,_2,.,,,1,,;C//< J If not injured in f,fin•·, state ~he;,, ~ Roo,,1 No. 0 '1 /J , Name of f.1ill e Formnn, f_L ;l/t( Q U-,,(V Married or Single ,,-:>?-> ~ •d.. L ci!u... :._~£ f c,. -o' ;{ Age of Per~on (_iur9/. c., ~ ~ Na•" of Mi11c S11pt, What fa1mly, '(u;iiy, How long in employ, of 0o., { , ) 0o9ditio11 of Life or Qircumstances, Nro,ie and address of ,ware::;t liuing Relatiuc, 1- t.J-c.,,,,f.?.. ~ ,,_--t.,A., J:::, was he an efficient man, ~ e .....1 • Was temperate, 1.,,.,_ 12.... r - ~ Where and i11 whose charg~ ~fl,/ Jj t,,./ 7T 11, , c tj ....____,,,_,_,,...,, = _----... Name of Physician calletl, i/-rintJ, i :r / ' '\ u<.__ ~ /4 ~ {! \- ~ 'tJ f/ 0, Name and P. O. Adress of Witnesses. Nature and extent of Accident, rZh ~ ~ m,-14' C, ,,u ,a,,./4 { (Signature) Date 7 C·7-IG .,.. ,~ •. OIi. ••••••••··· Title, �Form 123. rJ-JE TJNION , PACIFIC COAL CO. Mine No.········································ OF pBRSONAL INJURY. RHI'Vl\ T 8up'ts No...................... -············ ,, persoll injured, /Jame 01 / '1 J L < A . a.,J If occupation, 1/12¼ _,: / v ~ R. 3- oate of Accide"f, 0.. }~z. 1 /,, Locati0II, { I\_ L-_c /.{. 4 -/ 1 '-i.,, l.-C..r If not i11j11rad in fl,111,' state wpe, e, { (li J /4f .-C L/ ' ,,J .; Mine Supt. t t1 I....__ {lame 0J ' . . .// Age of Person ll1J1/1WI, _ / What Family, if dvy, /lotu tong in employ, of Co., <--' ·C / \ ___. / Name and P. O. Adress of Witnesses. ( 1 ,, , 1 , f 1 Name of Physio1an called if., any, Nature and extent of Accident, Entry No. Name of A1ine Forman, 1 ) !. 1 ;.... ( , ·,,..,_.(( , r < c.,( ( Signature) C-1-m.03. ,ou & 5 J t(i O Was he temperate, ..../ f'' ; ( 1 Room No. - - ~ 't ~ A ~ /4~ :,.,z -< J /? 0{ S1~1--;t"-drl-r L Date / 'Conf1itjJJ1 of Life or Circumstances, , e <J ( ~/I 3-f fl(____ (J tj tru.._L.,,,, -111ayfed or Single ~~ J , Where and in wl:ose ohara. c t, Time ----. 1/a,.na and address of nearest liuing llelatiue, ( was he an ej]icient mall, 790 fl1ine No. Title, (',l. >-~ C1 e.,,<J �Form 123. Y4 l'noN PACIFIC COAL co. fflE U OF PERSONAL IN] URY. Mine No.... . .... gb'PONT 8up'ts No.................................... )I 'Ji ., person injured, '1A a..,,,yvCL...... {lame o; 1 1/~ occupation, , "" //I~9 ,.,...-t?'(__ _;/ / ' /J oate of Aaaiden l,l✓L;J/J-rr , , 190 / Time l/ a. --vt-<.__ 7 "' 11 t :,, ~ Vt. Mine No. q £ N / Location, \ l '-re---,'- " { ry o. '=> Room No. . 1•arorl in Mi111, state/uhere, l I ff 110t II~ Name of /,line Suf)t, - {l 1 r \ / fa~i +_/(" Nnme of Mine Forman, /I~~ Age of Person ~njt(rr., _ .3 fllaYned or Single What Family, i/i.ey/J, ,,., /) ,J.._ '- IJ .. { ,I How 1 g in employ, of C o . ~ Y ~t/:::...IJ011c/1t1011 of Lif~pircumstances, 011 N""" and addmss of nearest /'uing llelatiue, a u-"'---,4 ~ jY.J was he an efficient man, (i -, -i(j_s /Je tee,;Jerate, Where and_in whose charg6 t, }/~!"' 1 1 ' / , { 1 JJl v f r> ~ - ~ /~ Name of Physician oalled, 1 any, ( 1 (I-( 7(/, ( • ?.....e--L o(..___ -----,:,,-:i-~ Name and P. 0. Adress of Witnesses. Natnre and axtent of Aecident, }1 ~ q__,'-f/.. ~ ,) )/~,,,c;:,,l..L</4 <--<-,. ,._, Y ti,,..,....,_~ , , ( , l ( (Signature) Date 1 Title, ·······-·· �~ F orm 123. raE UNI l RHPO R ON PACIFIC COAL CO. Mine No. ... ..................... T OF pBRSONAL INJURY. 8up'ts No.................................. . J ~ J (~f ..__. - Name O'I.; Person ~i11j11r~d, • • ' .,r_.,,VJ, .(,..-l/'1, 1,," 7/L a.-<.A.-occupation, ,yi.ef oate of A/cid¢11t, L 3 / ~ ~ Q '" Location, l { fn.,,ftl.. "f7,/\,,-{/'//(.../f? If not i,if11rcd in Min,Q/1 wfv , ,c of !,line Snf)t , 11 111 Age of Per~o11 1 11re , What Family, I 01 g, O .,, c.2 v :J r) }/(__ Time _ 190 7 fl/111e No. Entry No. / cd?f Room No. / --z_,t ) ~ :tJ_,!" -c4''( ~ 0 _.. ,,. r-,...4' ,.r ..... - i - Name of t1iite Forman, k Y~ ~ ~ MarrieJi or Single JJ, r - l r""rY2 /low long in employ, of Go., • /7 J ondition of Life or 0irc11mstances, flame and afldress of nearest liuiettRelatiuc, { / T.ln:- ~ o/~"--<-j;O ~ was he an efficient man, -;--£.,...,-:, /.J Wri}J he tempr/,dte,~ 1 /J Where and in whose oharye /cf{ ) t2 /1 -( J /1- - - , , r ~ / ) Name of p1tysician called, if any, ./7'-,.-- ~ &<-~ - b' L<__,_ o,{_, J.. Name and P. O. Adress of Witnesses. Nature a n d e x t e n t o h f 'JI J,1,, ,__ )/-eL.~ ~ ~tff ~ ~ cL ;/4' (Signature) Date 7 Title, ? �STATEMENTS OF 'W ITNESSES. p �F'orm 12:l. ~ PACI FIC COAL CO. rII£ u.~TOl Mine N~. ................................../ . . (Jr:'T OF PERSONAL IJ\ljURY. [<hf' J\ Sup'ts No.... ... .,pe,soni11j11rerl, (lnllle O'J . occupat1011, al )4.--oL- ' ~~ Date of Accident, Time 790 -'/ Mine No. )Jrz.v !2.D - Location, U ,wt iujura:I in l1i11• . t.latr. where, ,1/. -1< ,, , of !fine Supt. { , ~,._.,, ya jJ c,. e 11 111 Age of Person iJ#fred /f / • What Family, ~11/J, 3 e.,,,- ~ ~C<-<.... a.. ,.,..,....._.._ Entry No. (.p -/JP Name of Mine Forma11 , Mar 1ed r Single lloom No. c,; r l:-.,_,..,_l' ~ n_ ~~ o(._. <1 How tong in employ, of Oo.' . ~ U ~ ~ ,Condition of Life or Circumstances, Hame and address of nearest ltumg Relfltiue, e,f'-''--c.-( a__ Was he an eflicic11t man, Qi, e.. J Was he temperate, . ~ Where and in whose chargcalJt, c:-,..;9 L LJ c {( r , r c£ { , _ ;//:,- / c) ~ ~ c,- <?.- { v-rName of Physician called, if any, C Cz.. <- l,.._: c ..L c • d Name and P. 0. Adress of Witnesses. Nature and extent of Accident, ✓j n--z---l,.,~.J... c cf._ ( 3 . _ ~ r/ pc J-.P<k fl IA-<. c....d!._ tr I (Signature) 1 ~~ ~ Title, -.,P // ~~ , �STATEMENTS OF WITNESSES . .. Lf ;L , ,; ,.-,_oL_ ~ :!J (2-r,_ )~~ ~ L ~ Z-L l (J e_~ I~ l -:f - ~ ,_ t:_,; ~ 7 ~ ~-~ I ~ JL I: fl tl-: ~ ~ --zL~;,,.td t~,;J ti ~ -t_o~ I~~ ~ J~ I Jr- ' ·rv?/V e.~ -# 3 £:..:_ )Zv I I) e-~ /1-<-~ - d'~ ~~ ~ ~ ~ l L ~ -r t:L~ ~ - Ja-.-<;£, ~-~ i,,,v--,,..-., ,,,...__ Zf._.j L ~- ~ e_ a---, ( ✓ ~ I --1· a_~ <f- -d_,_, ~ t?«-<-<-a ~t -0/2 Meo! !Yhllt f Holll /01 !laf11e a washB l'/here 0 uame 0) r- e-~~ ~ zL //111118 ' C <...._.~ f ±., 1/ature , Cause, �t,'onn 12:l ~ PACIFIC COAL CO. r1rB 1n-iroN_ - Mine No.............. J , F pBRSONAL INJURY. plipoN1 0 8up'ts No............ , ./l _r/L ~~ ,1 Person 'i/11 uI e , f/ll/118 OJ. _ / P,-t,l...Cf._L-...r- L} ))_'yl. c,_ u • 0CCU/JlltlOI~ if Acc1de11t7 / o/ ~ . 190 Mine No. oate O ( I '( tn.,f"'-t v ........ /,/I.,(. , ,., -::, . cat1011, l0 . . red in· Milli', state where, If not ,11111 Time / fJ ·a . >--vt__, 0 Entry No. / 11ame oif Mine Supj,, / .: ,/. ____ ,1 AY ··, ie of person 'njure Y, {) l '-- / d -f &.- cJ( ~ , - ¥ Where Name of Physician called, if any, U--<./I .. /J . RelrLttue, Room No. Name of Mine Forman, / • M • rlnr arne"\:!;) ISingle V It..e.. in emp_toy, of Co., Holli Iong d address of nearest liuit 11amean Was he an efficient man, d iii whose eha e 1eft, a/I S' f./ 'l/Pa... rr;;;;-- 9?' • What family, f P v<- • / ::L.-t---<-t..~ . O&_ondttfOn of Life or Circumstances , /<{ S ) ; ~ 0-zy!- L<!.-u Y.n-J 0 )A "-P Name and P. O. Adress of Witnesse~-- Was he <Jmperate, ~ fhr}J_ )/7r:,;j,,_,,_fa_e_ \ , ,,D 1 J ·, "' A>'-/n ~ £ p -'" -/:1-A....... -r_ c__ v ~ ~ Cause, ~, (',0-- ~ 1,)/w,/,;cG 7, ~ f e-J dz,,,,i ~ ~L -f r ~L f:.-c.eA e..Le &0 L C c......,_ / ~~ C0</4-o0 Ph~~~ (Signature) 7 Title, . , 1' �STATEMENTS OF \VITNESSES. ) �, ' 1 , . ' ..,. Ii I , ~ ti. \ ,t.,, . ,.,, .;,, .-, .~ f. -- r l~ �• ( \ , ; , ( .. '' , ,. :, ' :;;;:7·----- , - -~ • • e,-. ~ -r. ,: ~ I ,. . - -' ., A . ·~ ., ti' ·, �· · ·· Mine No. Bup'ts No , (Jame OJ I, ocouPatio11, . () 1A ~ . I ? _. o(lteof Accid~ t, Y,'/ f ~-c..-AC:...-c--.. . ~ locat1011, . . ·e f,1ine, s a e where, If not tnJU' A-~---- II /3 rY'cf l"b ·- 3 1 11,meof /Ai"' Supt. (J..,{!..,,,; , Age OJ,F Person injured,--; t family if any, /-&" Wha . I 'r .t:) L-l .A .-' ' 3 L/ Time i:10.rf?~ Mine No. I Entry No. <g -I'~ " -/- Room NO• - - - 790 ./) vYzrt [A.__4 .,,1 ~ cYJ:- r Name of Mine Forman, nV/ • fl lj arned ors· I ~ " L/ ,mg e <-<. ~ J L~ II Condition of lif, (J", ")17 _ nlJ e~ o cumstances, r HotU Jong 111 employ, of Co.' fl. r;:r-,e_ ~ address of nearest /iuing f/elatiue, (j) n +-!lame and -"""-' LR../2_, was /,e an effieie11t ,nail, / ,-fl- Cf Q_ Where and in whose charge_ e1 ., O~ iam• of physioia11 ea/led, if a11y, .f5r' • ~ ~ cf1 ~ ~ J ~~ . J ~ ////~ cu (Signature) 7 /) , Nature and extent of Accident, Date (! W he temperate Name and P. O. Adress of Witnesses. , . ' ··············· ••••·· ~ ,, person injured, J; 98, ••·····••••••··' ••·· · .. Title, I , ~( �STATEMENTS OF WITNESSES. ,... (t'' (:l • :(i' ,, j(iOJ �rnE UNION P ACIFIC COAL c o . Mine No. ..................: ....... J?8PORT OF PERSON A L I NJ UR Y . t ... 8up'ts No............. ..................... Name of Person i ured, occupation, aJ_ •O.. <- t. ~J ,-.,., ,J_ ~ ..,, - t _ oate of AccjdcJt, Yl'l.P-t ~ /f ' Location, l.J[ b"l' ~--er-:.;, If not injured in /11i11,·, sta where, 790 Mine No. A ll· ~ Time I iJ 2 //.' oo tl. K_ Entry No • I Room No. 7// 2f /, ,,0 sud✓rb/z.e f Name of fl1ine Forman. J~ &.A,.j o-,.,c Name of Mine Age of Person injured, 5" O , Marrld o' Single 'l"'n ~ c - l . . What Family, if any, .J d'-:..J!. ~ <..-<... _ /} How long in employ, of Oo., // ~ ~ ( . . , ~ Condition of Life or ircumstances, Name and address of nearest liuing Relatiuc, / ~ ~ ~ Was he an efficient man, , ~ as he -t;;;perate, Where and in whose charge{§ft, '}1 ~ ;/J/l a c..-Ri "'-- = a_, 0 Name of Physician called, if any, Y-Z' ;.J--/-2_ <--<-c~ ~ ~ 0 flame and P. O. Adress of Witnesses. R ~ f t. u ~ f, () {'4 .:-z::__: Nature and extent of Accide!!t, °'---<- c:<_ c..~ . I (Signature) Date 7 Title, �rHE UNTON p,\CTFIC COAL CO. .i: REPORt _ _ __ T OF PERSONAL INJURY. 8up'ts No. ••••••• •·························· Name of p,rson_injurod, , r./! u ., 1/:?,rt! c ~ occupation, , ) )l..-): / / - ,t,t,.,J oate of Acr/d~, I/ . Location, ( 11 11 l9 A. z -,A~ f ° If not injured in 1,1inr, slat where, (!...,_l'rl A flame of Mine Supt.• .t. / T90 ,7 U Mine No. -~/:~ ~ e.--I! • ot cJ9 7 J: o:J } J/(._ Time IJ -. Room No. Entry No. J! Name of Mine Forma IA.J ~ • / 11 17 \ ( ,,JL/1/. 1 ~ '<:J Mar ied r Single ( c.t. -1' 2.... Age of Person injured, What family, if any, ;; / • • _, 'How long in employ, of 0o.' ~ / ~~yut::/t_t>11ditio11 of Life or 0ircumstanoes Name and address of nearest liuing Relative, f!::/ > ;_.£ - ~~ "° 'J , Was he an ~fficient man, Where and 111 whose charg, e. t, 'J../.- ,_,,, Name of Physician called, • any, -,.1 <vt <c~ _ X - Was he ,temperate, o/4 ~<--<-fl , 2Y'? /J c,;?" _.. c,,{ ) _r/ 7J A.-{"' • ~u J 'J •f.-e_ ~(2_,..,0 , Q )/J~ .-,4 l a ~ (j (;O cULJ2-e a ~ Name and P. 0. Adress of Witnesses. Nature and extent of Aooident, L /)-'/l,~ I d./!,_~ u Lu,< =, o- Cause, (Signature) Date 7 -I~ o{___ (f • ~J /i;, ;J,/ Title, t',___, ~Jt..,:,_y (/ 1 �STATEMENTS OF WITNESSES. p/i !'l' I tFi d·<1 /ii' . pr.= I 1:)51 ff5t �li'Ol'DI 123, ~ UNION P ACTFIC COAL CO. rau - Mine No....................../. J?Hl'ONT OF PERSONAL INJURY. 8up'ts No................................... . , pe,so11 i11jured, fl(l//1 e 0'j I ~0 - ,P -~,.: h / - v ~ ...,.. ~ ~d-u-,- c d occupation, ~ L:t:conte of Ac~nt, c/2 Location, {If IT"aA J_/~r If 110t injured in Afillf', st<Ffu whe;e, ~~ Nnme of !fine S,q,t. ~ 790 Mine No. W-~"< J-/ L/ Time g ,' 0 <1 ~ Entry No. ~ /J --jl 6- Room No. Name of Mine Forman, Morrie o i le Ago of Person i • r 'd, -2 ~~~ 1 Whnt family, , Y, ~ Hotu long in employ, of 0o., ~ t;:f-c- ~ Condition of Life or 0irou~ano;s, Name and address of nearest liuing(jelatiue, ~ ~~ ~ was he an efficient man, ~ , Was he temperate, Whereandinwhosecharge Bf, ~ ~ J~~ U U o-6""Y ~ •>1-//? -<-c ' Name of Physician called, i any, :;!::f-e-o V Name and P. 0. Adress of Witnesses. Nature and extent of Accident, {:,___,_ cf. t t"~ J t.r-,,., ¥ t "'-<-<- ,,(_J ,-n,z ,,_L'\ 'I ( (Signature) Date 1 Title, t ��ll'orm 12:J. THE UNION PACIFIC COAL CO. ,;....I Mine No. ••• •••••••••••••••••••················· REl'ONT OF PERSONAL INJURY. Name of Person injured, . oacupat,011, ~ ',U ~-/ < 1 8up'ts No................................... J-<---rz,/l/1l--<..-L~2-.-,,,_, ---- ~z....-t'J""'),-"---',._,~ __,,,, oatc of Acai~. Location, Ult ~~ . . If 110t injured 111 Mme, stat where, - /6 / <t ;I •Time j {J ; '3 tJ r• g ,_ Mine o - No. 1 / , ~ n tNo 190 e,., ~ r ...,_,,, ,r;:y-e a...J-<. Q./ . ~ Room No. - Jh,.,,;__,9,Jz,,,,;L9:1,,i;: Nnme of Aline su,,t. Name of Min, fo11nan;-~ Age of Pcr~on t, ~ -~:: ----._ Married or Single ,/';J-c.-_', ~ What Family, 'i/_!J) Y, r ~ {/ How long in employ, of Co. , [l ~ , .Jljmdition ofJ)4 or (Jir n n s t a ~ r n flame and address of nearest liuing Relatiue, /3 ~ U { ~ , r' '!P'Z Was he an efficient man, Where and in whose charge left, Name of Physician called, if any, ~ .,.....__,,_. . /J--,, ~, U ~ , r u t:-&._ .... - ...., ~ kJ- R <- c Was he temperat, ~ ;r r ---- Name and P. 0. Adress of Witnesses. t Nature and extent of A o o i d e ~ tlJA.e--r- G?vl u ,/ I Gause, (Signature) Date 1 Title, �I I • I I '\ i .. �I • I �l!~onn 123. 1•f1E - UNION PACIFIC COAL CO. -- Mine No. .... ..................... REPONT OF PERSONAE INJURY. 8up'ts No.................................... J 1 z~~ J- eu a._ . . 9 T~ Name of Person IIIJUl'ed, ~ trz,(!., Oacupation, ) ) l v/il-<.-C... : 0 LL oate o,.~ ACCI(e{, O..,,,,v-z--<-~ ;,/1,, I J,A 7 / Location, · /JC!-J.f{ ~ - ·- ,-,j,,,-l_r If not injured i11 Minr, state where, /lame of Mi11e 811pt. Cj}..,,, 'o/!i fc, '-/ 190 Mine No. ~A' Time / c... ' Entry No. Name of Mine Forma11, Room No. 3,3 ,1) ,,_'JI'_. J...--,...,.__,,____,_/ Age of Person 111:fureJ', Marned or Sin~ ,1 } 'J,"Z ~....._~ ~ What Family, ,fg,Jly, :J --z..-- ...r-D How long in employ, of Oo.' 1'~ ~ Co ndition of life or Circumstances, liuing e atiue, yJ~ pf,/u-, 1"'7/7//-~.... Name and address of nearest ~ / / , n a €.A _ C<. tt._,.. Was he an efficient man, Was he ten perate, Where and in whose cha '[le. left, / ~ ~ -e ) ~ / '--<---( cZ::.,e___, ,-, Name of Physician called, if any, i'\ c ,,Z *~ i1 I ½r/-- / <-e "'> Name and P. 0. Adress of Witnesses. Nature and extent of Acaident, C,,.,t. ,,.._J rf l!l {id t i u ( (Signature) Date 1 C·7-m.~·-un Title, 'I ' <) y r 6 ' �/ I I .. / I \ l , . .f �•'• . I • ., . ' .: " \ •. \ \ . . , ••• \ J \ \ .,,,.---•-.,.J r . •.•-......... ., ., t ' • I.,,, ....... ·,. ~.,;I ..~ \ .. _.)<-•~ , ~ . .,. _[~? '" ·) I I t l ' , .. \: . :'l• .. I '\ "· !' .: .. . ; • .J, • ..:,..-. ..· V ... ..· • , , .,.., ... -;• -... •. , ,.->. \ •, ,_),,·>,, .:,"""•....! • s: l ~"-:{ 1'--:' •" • • · :. .., '\_ \ • •I•• . t - "~ t • . ) .._. ,.. ~ •• , _., -1'~ \ :J . .• •' .. . ) ' . ··:\ :..:i.~.!"•r· . \ • Ir · .. •,.;\~ ~ �Form 123. UNION PACIFIC COAL CO. r rJE __ . __ _ Mine No......................\ ,r OF PERSONAL INJURY. RHPOI\ 8up'ts No.................................... (/ ., person injured, Name 01 • , '-,.JJ,."'l,~ occupat,011, oate of Ac ide1 t, YrL v_l l,,,-. . U I )'Jl.<.-<-,<_r r~ :A.. c~ f · ioll t.'1-'f!_. f ,.__ i ~ ~~ '1/ '--- -vv.., Locat • . ,;,,red ;11 {.1i11c, st e where, /f 110t II~ '?. 6 ~ u 190 I Time JJ ,· o o Mine No. / Entry No. P. --~ 'l' 3 Room No. t/2'-"- 2-'-7 J, ½:;~ Name of Afine Su~t. 1 ;-; ~I'<_ Name of Mine Forman, tf) ~ Age of Person in1ured, Married or Sin ·;-' ~ t . . - < ~ WhatFam'.ly, if any, - - - - . . , .. U ~L How Jong Ill employ, of Co., --1' Condition of Life or Circumstances Name and address of nearest liui Relatiue, cL a.r ,,__ ~ was he an efficient man, S -J. V , Was he temper a t e , ~ Where and in whose charg . eft, -c...,__,_.,f- t-r., ~ ~ rr7 CP ~ 11 Name of Physician called, if any, ~ ~ 'Jn c..,i -JJ-~ °"- c.-4 , V U Name and P. 0. Adress of Witnesses. I r I I ( J \f ')' "I r I ' (Signature) 1 Title, �STATT~MBNTH OF ,v1TNESSES. {tr . • .. ' I .. .• • uature and eri C~use, ),l. f'h>- a;,, 'r'2>t -1..t..{_ ~)l J cir I-¼_ A I �Form 123. PACIFIC COAL CO . 'ffifi UNION_ REpoNT OF p JSR SONAL INJURY. .~ Person i Name 01 . red, /~~ {2,-,f__/) 0 o--v- A -~ occupat1011 oate of Ac ,de t, CL/~ ~ -1< ") r /./ . Time / ./? : o (..) ~ ff1ine No. C'Y"" Entry No. ..u i!5 T Room No. . f i,. ./ • ~ !f{J,/4 ~ Locat1011, . . ,red in Mine, st te where, 190 ,< J / If not 111ft .~ f,fi11e Suptc..~ Name O'J 4 . . Uf --J ~ 0 !< 3 Name of Mine Forman, tl::Q --A/7.i' ~ r ..vL Married or Single r /J ~ C<---:, Age of Parson 111JUl'ed, What Family, if any, How Jong in employ, of Oo. , • r o n d i t i o n of Life or Oiroumstanoes, Name and address of 11earest~iu.·11 Relatiue, O J L - ~ 9J? _ 0J ~ ~ was he an efficient man, , Was he temperate, {!j_.9---::, Where and in whose charge le ~~ ~ Name of Physician called, if any, cE""" ~ ~ N~ Name and p, o. Adress of Witnesses. Nature and extent of Aooident, ~ ~ o(, (Signature) 1 Title, U I �l•'Ol'lll 1!!:I, N PAC IFIC COAL CO. T OF PERSONAL INJURY. ~ t1NfO.1. r JJ n 1uwoR Mine No. •••••••••••••••••••••••················· 8up'ts No................................... f ., J ,Yl.-dCL,e e....., ., Person injured, 0 NamB , . -;,,.y1, IP -' . __ l CL c... <- ~ occupat1011, 1 oato of Accj{(a;;J, L • {_J( trc rA. t 1 ~~:::> ~ Nan" of l,fine Supt":':.. f ;f /.':LP,,_ < • L/ . 790 Time / ,' 3 {J P .............__ Mme No. ...-Entry N"--. /"/l v. Room No . _ ~-<--<.; ~-- -<--<-..~) ✓- < J y,o Loca ,o,, . . . • red in Mme, state uhet e, If not tnJU - k c = / Name of Mine Forman, J t'J-- r) 0 _,...,,.,_ ,,_,.,_/ Age of Person 111JUred, / Married or Sinh!_✓ ~ ~ ~ What family, if any, - ~ 0 e... H w tong in employ, of Oo., • /) Oon it'on of Life Of Circumstances o nd address of n.e ar~tliuing Relatiue, (_.,1r oc--A_ y::, ' Name a d..,__ was he an efficient man, ..Q.---0 Was he temperate, ~ Where and in whose charg eft, U--..,o-.,,..-.,_ -y✓ (✓) U Name of Physician called, if any, ti'? /J /i .>-<- .. r,,R. n Name and p, o. Adress of Witnesses. Nature and extent of Accident, I f I I ,I ,ij . I !: I I Cause, j I • (Signature) 1 Title, I I �• t C ., . ~):'-~~ iI -4 I :; J II t) ... I I • J : \ I~ , I \ tJ /._t ,. I ' , • ' . i- ~ ~ �r I ¢. I c'. .i '-f&! I "' I n-- • ,. '>z .t? ,er,. 'Y. 11-""1,/ A ,. ·~ V ,, :9t -".fi' X .:I ... .,,.. ., ( V~-t(/-{. y. ~ " . I" ,! ~ .';"\ I 1 . I 1' r , _,, •! "'.t r ~ (' 4 ,. " ,- ( '. (I t '"" • ...< Jf f ,. ,c (j {: \ '-( , ..,,..(:' ~' , I IL ~- ·-!. .. , �,., L I \ ) .. .~ /_:?.- . :, /J -~ I ..,~ .c- ~ ~ ., ,· .,. )· I I \ er!~~~ • ,,;,,,,,, \ A ~, "'• "'?.---<-'- ,I ' . { ✓ /( t 1_ .: I~)? ��~ P ACIFIC COAL CO. r v.NJ0 l • PORT OF 0 • • d L of person !11111re , , Jc! ' )1'1,,,t-~ ,pat1011, .f AccidJn, , o, ~ 1 . ~11011, Mine No. PERSONAL I NJURY. ,, ,.. '/I,, Sup'ts No. Jo c,-/4 d 1 • 790 ~ Mine No. v /3 , (Z,c..~---y ' , 1/ a' l 3 '--6--.. '---~t family, 11 any, _ tong in employ, of Oo., 2 •"' " ,.,. 17 u :P and address of nearest liuing Relative, p10 ,o ,, he an efficient man' ( j ~ C' c d t::/ r: 1me / I I /" Entry No • a. ..... ...__ .____ L ...., ....J Room No . Name of Mine Forman, Married or Stngle • '--'<..rl/r- ~ 7 ') ,,i ,.::, _ iere and in wl~ose charge_ I ft , /b-; r r ~ me of Physictan called, if any, f: U II , I -,; / •~ - ~'--< ,,,,C,-- t-J- Condition of Life orf2 U r. ~ , . . ~ 0 ~,""), ~ ou/2tanc®J. ._,~ _ u....-~ t/ ti;,. ~ ' I 1 of Person 1111ured, ;.; I "' - -------_ _\_ ,,e of f,1ine ~u~t. I ~ ( . ,iured iJ Mine, stat \ w iere, 1,t II!, •••••••••••••······················ I / ;r t 7 !'0 r ~AA,.,,· o -, vt..--<--'!_I V --;;, () . ·e,..t.__..Q. ~ ·" [ ,~ #- !t . : ,<-1211 t . , , ~"\. )Q~ ~l--£-<'. Was I1e temperate, ~ ~ ~ i l . )/.--cA-~--:J v / 1<....., J' I, ,. ~ 1 C( ~ tz_ ? r, 62;.e) Sh / 5-"" l"'e and P. 0. Adress of Witnesses• .hture and extent of Accident, ~ ~ c;;(_ L/- ~ d.-1 6- f 'I 'I •I I II I' I r 1 I I , 'j I I I I • I �,r1JE Form 12:1, UNION PACIFIC COAL CO. pfSJ10R . _ _ _ T OF PERSONAL INJURY. V, ~~ ,; Person injured, 0,1,,,:;d, 11ame o; Z ~ occupation, ~().._ .u_,{_,I 0 o{lte of Ac°(hifi!'"t,/ i, vU..-ie • . tr:': "( ?,~]...,/L;r Loeat,011, . . . • iiiured /II fl?,ne, sta e whe1 e, ?f ff 110t 1/'J .P/' 19of/ Mine No. Time 1 a., . ~ Entry No.t/Ju, f)(j¾ Room No. I l I l J ~'7Ll 9 Name of Mine Forman, Name of Mine ~u~1t. t::. ./.- ..,,_."~7/!..b-0- It{_ Aeof Person m1ured, '7 Marri~·Single g ;; ;/~ What family, I; any, ~ 00ndi ion of Life or Circumstances How tong in employ, of Oo., b ~ _... , Name and address of nearest liuing Relatiue, • ~ was he an efficient man, ~ c__, J Where and in whose charge I~ (2,,,f--- Hr-z-~ Name of Physiaian called, if any, A /"Y- -~ ~ Nam• a,d P. o. Adress of Witnesses. r ~ J:,_ Was he temperate, ~ fl j\ Nature and extent of Accident, Cause, /I (Signature) 7 Title, �STATEMENTS OF \VITNESSES. A 6 D b I I) & ' I. ~ e !I f ~ ,, s: �l•'urm l:?:1. N PACIFIC COAL CO. ffJ~ UNI O1 y J.09 ~; Mine No. OF PBRSONAL INJURY. ,nu'oRT 8up'ts No. .................................... a 0,-F Person injured Namo 1. 7l/J✓, . occupat1011,;:d oato of Ai•t• e t, Locat1011, in If /10 t I'niured 'J ~ ~~ I r . 790 1 Time ~ :<- ~ m, , sta where, ~ Name of Mi11e 8•~~ ....,,,.1 H:l..f Age of Per~on :nrrey, __ - ~ .- ~ What FamJ/y, if an , How long in emp !/, of Oo., . ~ and address of nearest humg e at,ue, ?/. N t ame _d(efa~ Entry No • Name of Miile Forman, .. <../ 7 Married or Single ~4-~ ( U Room No. ~ ~~ Cl • r,.....-y-z. "---1: Was he t e 1te,n p ~ r ) ~ , - A - - ( -- • / - Name and P. O. Adress of Witnesses. Nature and extent of Aooide11t, ;.J~I~ J J , ;_ - , c I ~ ~ (Signature) Date 1 C-1.1:;.03 ··OU. Title, r ~ U_ ~ Oond,t10n ,,"f Life or Circumstances, '7 Was he an efficient man, ~ , Where and in wl:ose charg~ t, ~ :J--<--r-<- -€ Name of Physician called,"-if any, U ('>_,....6 Mine No. ~ l ~ 4 '\ l J / 1 11 I JI CL<,. ! I I1 I I • , / • /1 / Ii �I • ,., ' .- �UN[ON PACIFIC COAL CO. ,rlI~ - - -·:ir RRPOli Mine No. .............. ... OF PERSONAL INJURY. .............. . 8up'ts No............. •....................... ,.; Person injured, Name o, '-yyJ . !J-r:.r-L-v1./ ~ ~ , , . - v - z / ff'' J -J occupation, / / 1-- ~ (} ____J oateof Accide~t, -~ /Jc!':_~-:-· 790-'/ Time / / u ,-----L,_,_.~ q, ~__d>.--c.~~ Mine No. I E # 1 Location, . , ntry No. 7"'..c-£.. J7 Room No. .,1J·ured in Mme, state whe1 e, -; ,-1 >:w, ?'-/ • -(, If 110t I Name 01 Mine Supt. . . (}_o- ,u . / /2. e-r_ -cL,..~a.--n,r,Jqame of Mine Forma n ~ ~· , :J,J 7 -~ r -- ~ , 'b;,;f, c-_ r,-,; / ' / • //; I _.7~"7- d - o' C . ~ _ / Age of Person mjltred, Marrie or Single 4: ;._ _ J---<../ What Family, if any, , __ ·~ J?How tong in employ, of Co., 6 ~--~ J Condition of Life or Circumstances, Name and address of nearest living Relative, >n-✓.:~--V?/,, >/(---J CZ:ZLa.--~t?----J?, was he an efficient man, ~ _ Was he temperate, 0~ Where and in whose charge left, ~-<.-a / .--,>~-:::L-z/ / • . eZ.~.1) , Name of Physician called, if any, ~ v• / • / -/-; Y--o--,.-, - : n - / , Name and P. O. Adress of Witne~ses. I 1 ' ~1, : ,t ,, I 1 1: !\ 1 1!1 I 'IIi i, I l rl li l.1 Cause, ,,I (Signature) 1 (:.7.1, , •. •,•.,.,..Cll, Title, �STATEMENTS OF WITNESSES. l 111 I I I I I !ft1llle oj Mc of 1 w11at r, Jlolll Jon 11ame a, 11ashB Where 6 11ame o; pamea flalure • Cause, �ll'o1m 12.'l. fIIB UNION PACTF~C COAL CO. 'T OF PERSONAL INJURY. Rl~POlt of Person injured, / p l a:-;r7"L.; •'<! /4/ -q -d d ~ - : ? : 7- J Name t. _ ✓-~. - ~--c,, ~ < • ~ ------r~ -z.../ ooolfpa /0/1, 0 e 6 oatc of Accident, r//. -c ,_,, 1 . (} ( , _,,.,,,o: _,(! c r _f. ·et x Looat1011, If not injured in A1inr, state where, /1 1 . II 190 .1, r Time Mme No. -->_ 7 · P ~c. --ii Name of Mine Supt. ~ ,,,.;1~ /j e-< ~,d--;;C,-r::(A:;.v({/ame of11A1ine Forman, fo-,,,,,'</ , '--,;:°' <'--£ Age of Person injurr,/ '-> 'd Married or Single ~~~ What Family, if am , .._ , How long in employ, of Co., ~->1.-(" ~~ Conditi n of Life or Circumstances, Name and address of nearest liuing Relatiue, ~~~ V /~;, ~ - J 7" .:~/ Was he an efficient man, ~ _ _,t? Was he temp_erate, Where and in whose charge left, / Name of Physician called, if any, ,,dJ.,,,, _ ~ /<><- ~ . . - , / ----,-._..~ ff~· -~- - 0..e.-a/ /o&-v. ~ - Name and P. O. Adress of Witnesses. l ( fJ. t/ I I ( (). I - ,, ·I l (Signature) 1 9/Title, -.>-YV, 0-~ ~- n(~ d ~ ~ �ST.ATKMENTS 01" \VITNBSSES. I I .}.' I' , pams and p. t Nature and e. I . • I / .. , ., . I ) " . ,I , ,I ' , I f I CauseI -1 ~ 4. .,,t;, ~ 1-: �THE i:• J:t· Form 12.1. UNION PACIFIC COAL CO. ,. Mine No. ·········................................ nT OF pJSRSONAL INJURY. REPOi \ 8up'ts No.........................( .......Name of Person injured, occupatio11, 7?7oate of Accid~t, t. ~~ ~ 71 _ Locatio11, (fl---_,,..c,..,f -~/:> ~ If uot injured in Mine, stafe where, Y , r, -~ L) -· 790 ,-;- Mine No. Time 7 7•' 3 " C? , 'Y.J1, Entry No. a~Room No. L Name of Mine Supt. ,,.-\C , c. , ,. , ~ - L. c<. ~ : ~ Name of Mine Forman ~'Tl---0 , o<, -/J I " , ~, , oC.i.d,_ Age of Person injured, .:J--- .?- ~ ~ d rSingle What Family, if any, How long in employ, of Co., / }1/z-Condition of Life or Circumstances Name and address of nearest liuing Rel tiue, ~ was he an efficient man, <---:z..."-<Z.._.,, Was he temperate, Where and i11 whose charge left, /~ \.:ft../4-'";_,n__ r/ Name of Physician called, if any, ~~ C() e.. I ~ ~ j · / ~ cp Name and P. 0. Adress of Witnesses. Nature and extent of Accident, Cause, C.7 1· • •·03-.uo. c-c( 1 �STATEMENTS OF 'W ITNESSES. �J(o Na Nr, {(,✓"- tvj ('. : t• {J, �JJ3' Form 12.'J. UNfON p,\CJFIC COAL CO. •rJJE J?[WOR T ·- - Mine No......................................... OF PERSONAL INJURY. Sup'ts No..................................... ~ ,., person injured, Nameo; ~ occupation, / (' () oate of Accide~~. ./ .:. <-(),,.......~ Location, <;57;:/~ C1/ ,..._- ( lf not injured ff(, Mint', stat/ where, I ,, 7,, 190 >-f Time ~ ..:> Mme No. / Entry No. .::,. c;, .>?( ~/- 7"- Room No. ~~ Name of Mi11e Supt. a,[v;L Name of Mine Fol'man, 0 Age of Person injured, ,,,'2 t/ --,;J- e..- f-t--Q_/ Married or Single , ..,I, , 'q ~ What Family, if any, V~~ -P / :z- ~ - .;i_ How Jong in employ, of ao. I --3 0ondition of life or Circumstances, Name and address of nearest living Relative, c;--~_, _? // ~ a - •. -• J ~ .JJ was he an efficient man, ~ . Was he temperate, ~~ Where and in whose charge_ left, I .Pl.;:;--~- ..-,_ 9 ~~ _.::/£-o _ } ~ Name of Physician called, if any, {/o<Y--v. G. I ~ r/J}_~____,,.__,,,,,f; Cf ~c1~-? r ~,?_,AZ- _ / k ./4_.. . Name and P. O. Adress of Witnesses. Nature and extent of Accident, . ~ ' µ I Gause, ;Jp I i,,, I I' ' i (Signature) Date 7 ___.Ill �STATEMENTS OF \VITNE SSES. lie �T J-JE uNrON NJWORT F orm 123. PACIFIC COAL CO. - Mine No......................................... OF' pJiRSONAT., INJURY. Sup'ts No..................................... • • ed, . e of Person m1ur ~ -~ /d Nam a, ,, -1-d_o--L ,. , ~ ~ , =f / ,,....,_, _ ., J. "9-'- ~~ occupation, rv-<-~ ( /V,, I .E Acc~· den, 7 oale o, ~-~~1 L0cation, ~ . • . d in r.1ine, state where, f) f/llOtlll}llle rv-v 1-r . 190 ¥-· Time Mme No. /2-o . / . / GJ_,_j"°--....:,_~ du· / s , L - ~ e../, , • 8 t Q.-,<Z./ ~ Name of nffne Forman, of~ "t . . ,);?f ~ N eofMmc up. am • • ,reil >.? ~ Mamccl o · Smgle A e of Person mJt (1 • t:T gI t family, ,,;F an y, "W ia , Condition of Life or Circumstances, - 1 y of ao., ¥- ~...ll--=----z...-c:z-..-How long ,n emp o , ':)_,__. , _/ /,J / .I? ~ d address of nearest liuin ,,, , ~ .:;--.,--,~.........~ - . t . , . . . , / ~./1'.'. .., C... ~ , Name an ,.n; • t man ...,,_,._~-Was he temperate, ~ Vz Washea11eJJ,c1en I ~ ~ in whose charge left, __c::;; ~ . ., . 7..... ' Where and . A"') -- ;J ..,,¥ ~ Name of Physician called, if any, ~. c;;r, Name and P• O• o I . / - .- ~, Adress of Witnesses. Cause, I I (Signature) Date 1 ot Title, ~ �STATEl\1ENTS OF \VITNESSES. . He ,~ /.'a -' • wi f/a Caus I I I I �rroN PACIFIC COAL CO. tIIE UN .1. Mine No. _, , OF PERSON.AI, INJURY. NBPO li 1 •••••••••••••••••••··················· Sup'ts No.................................. Name of Person injured, oocupation, Onie of Ac • Location, ,, t •11iured in Min<', sta /1 110 l'J Name of Mine8up1: 190 ~ Time Mine No. where, c;t2-,n_., ~..J < ..Y-/ '-9 c) Entry No. Room No. ~ Married or Single ~ C· .4---;, ;;z,_ ~ ~ J ; f m a n , U, O .---z-;c...--..,...,~-'1S-L_,. Age of Person IIIJllled, ,.2. J' ~~ What Family, if any, .___. ~ How long in employ, of Oo.' .---:~ . 0ondition of Life or 0iroumstanoes Name and address of nearest lwmg ~ w , ~ Was he an efficient man, Was he temperate, ; /, Where and in whose charge left, »(-~ ; L ~ · ( Cf, ~ ~ Name of Physieia11 called, if any, Name and p, 0. Adress of Witnesses. Nature and extent of Accyen_t, ~ &!~ Cause, ~ (Signature) 7 ~ )~ • �=ENTS OF WITNESSES. STATE 1.·.1. • .- . �i ., I u ' <:-,-<4c:~.... ,/-:ir..,i..,: --1... l 'L/[~,{,-t:l tr~ ;/ ~ D- -·~.A..... C(....t:.e .4- '?,,.'r-f. •./. (,,,-t,- ...,:1 f'Yt-1.),,1 - --~- l?..,f.:A_ • ..£.~ .., ,,, • . • .,_..,I,,,. ., L r,,..._!),,.1Au..t { l ) 1,i" tJAJ d, • • :C/:i: cl~ a-r,{ I C- A,.,-d• ... a,.,..:..--u C (!~ J o ~-:td ( ;.~ , -;r . . .. . cr - ~ l,1-<. :/l17,-- • 7!"k "' 11--z-~__r;t;;- &t~ ~.f-d U/f- -5. f ~ G,; i,., ,I(,/ IJ :..t...L I j ii. I- .'.J1U-:~ ,.- • ,+,,,.. ''),i✓,y!_ i.41. ' - 'O v ,',7,f~ C{ V M -;e: )¼-.,""t,~·, ' v' _/,. ____ -,(A,Trr- ,;/ /){J_w( • j __ _ : ~ ~~ _.,. c:7'-%:,t; -~ .r, �_/ I ~ ~ ..\ •l •' .. I ) I .J .. \ : ... l ' 1 I 1 ✓, <I i //t. (. t. (' ,, l l/ G~ l -rt.' / .-;/ J...,~-!. ' ' �f ,1 I ,~ 1I /d 041 LDC / ,1r. I•. \ .•. f, .. {. .~ V.~1: t C .: ICt,t ,r • (.-....,. .I_A t C. ~, , ,I I ..~ (1 { .l I . I .1c I .6 ( ( ...... "' : ,_ ·v (r{,'" I t .'« ·,,, • 7.. --11 •1 ~ .~ \ '' ·~ ~ ( ,,;,' , {-(. 't\.' J .. (. {, \ l ��Forin l:!:1. ~ PACIFIC COAL CO. rJJE n~IO - - --pJSRSONAL INJURY. Mine No. ···-···································· pnf'ORT OF 8up'ts No.................................... ~cc/ ., person inj':':•~ . · ~ /7~ y • (}_<--< ~_,_,, .;L Z ~ 190 'T Time 7 o, - J - J_ ~ YVf ,F Aacident, (k. -_./ ~ -1 • ,, ., ( • oate O; ~ ~ ( / l . - ~, - -, Mine No. ...-2_ Entry No. ,;;J;:=-f-'-r• Room No. ,,;i. / 11 tocati~ •. . d in Mine, state where, Name o; oacupation, f/llOt Ul)L//8 J !. ~~~'--- h7, h I Mine Supt. _,,.,,,__,~~Name of Mine Forman, (!_ . ~ _ , _ _ / Name of ,•nitire , ;l- .3 . - . . p ~ _ / Married or S i n g l e { / ~ ~ I . . Age of Person . ' -C I Wh t family, if any, ~ ~ .. . , a in employ, of ao., Gond1t1011 of Life or Oirc~,ys~anoes, I 11 How longd ddress of nearest liuing Relatiue, ~ - ~ ( ~ 1) ~ ~ 7 - : : " _ _ ;,~ ·" d-_ 0111: ; Namea11 a ~ ~-f' ---~-~~ ,lfieient man, ;ias he tem~ er te, /,?~ e Was he an P' ~'-zk..... • 7:....._ ,1' Where and in whose charg~ left, • I',rLe_~~.:._ , ~~ C t ' ~ ~ /~~ : 1' ,1 Physician called, if any, - d ~-n-/ (/ ~ Name 01 U P O Adress of Witnesses. ~ ~ Nameand • • ;1~ - ~ ~ Nature and extent of Accident,/ ,/ Cause, V (Signature) M./ ~ Date 1 Title, »t d, �STATEMENTS OF WITNESSES. �pACTFIC COAL CO. vNTO~ ,rfJ6 -- --- peroR ERSONA T OF P Mine No. ............. ... .................... L INJURY. 8up 't8 N0• .................................... if~/ Id, d JJl-/?'N/ person injure/:-.i • .n / (lameof ~..., I/JatiOTI 1 acct ,1 Aocide , , . ~ ~ c). 190 ;f- rJ 9/.~ C , ./7' oateo, ~ t/;yp_ . f,?' e state where, lo cation,• 111 , 111, If not i11)Ure tlh ( ~<--'• Mine No. I !,1ine Supt. ~ {lame o~ , son injured, ,;L,/ Time / f o ' ~ q, Entry No. Name of Mine Forman, f_ - J ~ _ ,d_//4_/ Married o r ~ ~~ Age 1ra:i/y, if any, Condition of life or 0iroumstai:Jes, Wha • n Joy, of Go., n/ ~--~~~ - _.. , ,;o, ~, HoW fong rn e1 p 1 arest living elatiue, --'f--.,.,...,,_/ Name an d address o ne ,?) ~ Was he temperate, e an efficient man, ~ ~ ~~ -' ~ Was h . I1ose charge left, / () , dmW ~ , Where an . . called, if any, G_ ~ , ,1 p11ysra1an Name 01 0 Adress of Witnesses. Name and P• • (Signature) 1 /.?f, --- Room No. Title, �ST,\ TBNENTS OF \VITNESSES, con. ;/ii ·?, ,.., if . :<· . •• :Stat"3r.tent JI II of c. Ob i 1cn.-:a. 9 :"ine u. 'P. C"al ~o., near sir:-Roo!ll 33, · n i n ~-o g .. ~i"'e of 'i'he Un i nn pacific cocl Co!:11,.lany, ~ I ~as !D.i ni. g . -· • 4th ~ntry, a n <! I -cras \70rkinr on the 9th day of J ,ily, 1 304 , I had bored a hOle fir p o"rder and c.f tor h,,v inti sot fire to 09 squib, I heard a loud noise, 1 i ke t he burst in;; of t,e c oal a'ld I thou::;ht it "'"' II 3ut i t ··•a::; no t, a!'ld uhe n I ber;l..n to near tl'lr, fro~ the sh ooting. place of ,1or!,ln5 a. piece of co,J. f oll a!>d struck me on ri. ot thii;h, ttJt/1 fro.c t urinr; r i rht l ee;, an/ I co·.116 n t t e t in ti"'Tle. i'y purt:1er Chi bc. has been S ';lay rt occurred a bout 9 o' cl oc:<: in ti1e morni nr;. 7131 absent l a tely an,1 I c elled for hel p and ,1as a - i sted by _A_<c,roa, 11!10 in the next ro om, 34, c. Obikawa By T. Aikawa, Japane se Ag en t a.Tld Inter!)r e t<?r. �Form 123. ON PACIFIC COAL CO. ,-rr6 °~n _ _ , ., OF p£RSONAL INJURY. R,wo1( 1 {Y, ,; person injured, . 11ame o, ~ occupatio11, - ,, _/'---'"..,, .; Accident, f ~ ;7 . --4--:f~~...--<2-- ---- oate 01 Location, # • . . ·ed in Mine, state where, /f 110t //IJUI 79 0 £/- Mine No. / q f 1 Entry No. -1/- Room No. -3 ..3 I 4-,o ·., / -~ ~ _ / • \ Name of Mine Forman, 1 flame of Mi11e Supt. . . , of Person 1111uied, . Ag8 q.>n. t, 0 0 Time ~, Married ors; gle ,f7"_ :=4 What Family, if any, HoW Jong in employ, of (Jo., / address of nearest I iuing Relative, d Name a11 was he an efficient man, fl_/ ,, - rJ! Where and in whose aharg~ left, Name of Physician called, if any, / ~ j; I -"""'--<~..,_...e, r7) Condition of Life or Circumstances \../~_____ 1 - - ~ ......, , ~~ ' 11 was he tempe ate, 0~ A - ~ / ~ ~ a -t- x : : / ~ J , , C]? H- . q ., ,. cf, rJ' Name and p, o. Adress of Witnesses. it Nature and extent of Accident, {;p~/4£ ~ , It \::: Gause, (ii I ,11~ ~ (Signature) Date 7 h I �STATEMBNTS OF \VITNESSES. 1:a111e oJ I Ade off 11h1tt ftf yo1U /or:! IIj . ~I ,~11me an 1:11s t,ell wwean r,3me of I 11 111 1 11 I I ~I 1i1 ijj ' 11 ~ I ) nature an , I Cause, --c �l•'orm 1~. NTON P ACIFIC COAL CO. f lJE U.1. - - - - -T OF PERSONAL INJURY. RHpOR /i)-o-~ );// ,., Person injured, -a-~--~ -C<----~ '/ame OJ ✓ ,1 ( I_✓• /I • . / . , , - r - ,:,'C-G-1__ p_.. ••-, L c1 ~ ~ - z _ - , . _ _ ,,...{ e.--, cupat1on, r ~ ,2.. 0 79 0 ?'-Time c ,;Accident, //l---r-<--·1 /,✓., ~ / / , ' d 0oate OJ d J /4 . . M. N • , CL .> ' - - , - ,,_ - ttc/., ✓'/ r ·,.____.-me o. / Entry No Locat1011, • (} • . . red in Minr, state where, J L If ,,,un1• Mine Supt. Name o1 ' . . , a.,,</ o<'f] ~ /4 =·•L~ q , )7/. •c Room No . I. I I G. d . >~., ' ,,._,,.._ -~ ✓ ,.,Name of Mine Forman. , J;--e./ (Lj _,_- ) - , r~ ,<./1..,.,L---r.-<-.1---t- Age of Person ~IIJU!'ed, --~- "-' Married O Single 4_;,,,_7 ~ What Family, if any, / .. in employ, of Oo., . J ~ ~~ Oondtt,on of Life or Oiroumstances How IOng . . . 'I,.. • • address of nearest /wmg elatwe, / L - - r ~ ~ _ ,__ < ~ /-;:J d Name an (, ~t-e_,,- L~~~ Was he an efficient man, 1-t!..-<2... (} Was he temperate, 12 :..-P--o Where and in whose charge_ left, --~. /✓ - ?A- , ~ ~ d Name of Physician called, if any, .,, '' ,, \ 2 / 7 - _,,." 1 cJ . C. I t, ' • -t-/ I , Name and p, o. Adress of Witnesses. jl l i \ ·\ Il~ I .: I ~ I I I ' \\ iH I, (Signature) bate 7 Gd c;J:___J~ Title, :»;, ~ �STATEM.B;N'l'.::> VL' n .L..&.u....,u v .u..,, ,,, \. I ·1 'I \, ,.,., (. i I ' ;- / ( i II !I { i 1, , . ., I \': I ,t •, .. i ' Ii ... {_ _ , - .J r.' "'" \ I I ' ... ;,u..J .f 1,, •.. / ... . "' I i• I J ./_. 'I' • �I' .... • I / ! ' -.. ./ .,) .,. . , , .,, \ .. ' V ., I I I / . ,I ~ ,,,.., ~ .. • , ' .. J~· ) 'I ;' . . f';. -/ I. i:' ~ . ?/· ' 11amoand p I ,,. . .( / I ( I I. .f t~(_./.._ • I ) /lature and ·: \ ••. ·' :./- ,. , I, ' I ., l . I . I .. Cause, ' \ I .._. �l•'orrn U!.1. UNION pACIFIC COAL CO. ,r1J6 - - -f OF pRRSONAL INJURY. Mine No. •••••••• Ji'h'pOT~ ········---············· Bup'ts No· ········-··· 4 L ~• (3 ., pe,Soll i,ifured, , Namco, . l/l/1 /' , l ~ occ11pat1011, oatc of Accident, tacatiOII, · d i11 1ine, state t here, If not in;ure J ~~ Cv~y-f 7 .3 - - 190 Mine No r ~ I -- - ~ + Time 1 ,, u Entry No. ~~ + H•• tonY in employ, of Go., ?-. ,.,.,...j,,.,/ . I\ Name and address of 11earest humg Relatiue, washeanef!ioientma11, Where a11d in whosecharge left, ~ ~ \ No0 • )71_ , Room ,.LL- ,.:; _ -.5- . ~ 91 LL~ ~~ ~ - on_d~t,on of LiJe c - . • ,. ~ r G,rcumstances, 1 Y '?~ ~ ~ c?r~ , ~ 1 ~/ , /2,z, Was he temperate, ~ <2,-c?.' ,.,/__Q _ Q ~., -~, Name of Physician called, if any, ~ _Married or il,, ~ ~~~ a____# W,_,,,,. , • g,me of Miu• 811P1• 0--,l,-,,. ~ - - - < / ~ Nam • Aeof PerSon injured, ;)-/, e of Mine Forman, l:hnt ramify, if a11y, O , ~~ flame and P. O. Adress of Witnesses. Nature and extent of Accident, ~ ~. II l 1 ~~ /I Cause, \. •/ I i ~ /4-v ~r • (Signature) 1 ~ ~-i~ Title, ~ r �STATEMENTS OF 'WITNESSES. �Form 123. - oNJON p ACIFIC COAL CO. rf!6 ---- , t1ameo,_1 pcrso11 injured, if-. , occtt/1at1011, ~ '_.,aJ , __,,,.,,, ~"""' /4 • Sup'ts No. ••••••••····· ············-··· ,{.,./ , , / ~ ~ f L~ .- ./-/- ,,,, ~ . 79<f ~ Time oataof Acci~nt, I/ I.A--,,<---I i,,aUon, < : : . ~ ~ - , . ,iured i11 Mi11(', state where, If not u~ J Mine No ••• ••••••·············· ..... , OF pERSONAL INJURY. plff10l\ 1' Mme No. :Z / tJ ' Entr ,~ ~ /. 'f Y No • .S. );,;~oom N I > o. v,) ;,,,, ,.,. ,, (, ' t J _ d..- ~ I / -"/, ),/11 (lame of Mme Sup · (A- \.:V, P ,e-c- £ ~ Name of Mine-Fi . ., ,,--;:,- ,...., / • of Person injureri ;,'-J' . . : . ~ / ormaa, <./, ge _ C - -· · ~ Married or Single t? • ' A 11 Vlhat Family, i, any, -t:.e./ HoW /ong in employ, of Go., fL._.g, .2 7, , f " "r Condition of l" • / Name and address of nearell!iuing ~elatiue, ::.#-,?>V, ~ c u m s t a n c e s , (12...t.. was he a11 efficient man, fl..R..<U .:, 6 J ,f' CZ?. ~ ; . _ ~"t?,. . I ,-F 7 Was he temperat ,__..__._,, ,4---i • Where and III whose charge e, t, e, Name of Physioian called, if any, ~, ~ ~~ ~ ; ~ d- r l i , • , . /2 Cf! , I ' \· Name and P. O. Adress of Witnesses. Nature and extent of Accident, ~~ (Signature) c.7_,5 ~ 1 7 �STA TEMgNTS OF \VITNESSES. 11 �Form 12:J. •[ON PACIFIC COAL CO. ,rJ-IB U~ pEf'ONT OF Mine No. PERSONAL INJURY. ••••••••••••••••••••···················· 8up'ts No C-/ ~ • • ..ed >?l,,-rt. ~-(_ , ' I '} 7 7A .vz. -c /1./ if PcrsonmJU, Name o . /? ' ········· •...... ··············· / ~~ 7 OcCII/Jation,. t (} v<- [ 'f o2' -f j 790 .1.r Time / o ' -~17~;;( c;? oate of Acc1~n, ( ~ -c-P.-ct...-7---1 • J/~ 7'-u-Mine No. • 0 -<-")"?-" ·::ZI Entry No. I .£,_c.-✓-;:moom No. / Locat,on, . . din t,fine, state w 1ere, ff not lll]Llre /,,,. e su,~t. ) N meo1 11111 /'e of Person injure , g t family, if any, ci. I .,,Ij,,_ u d.---L___,,,,-- u ??J ·? 1 ,-~f e _9J . . .)r~ ' ~ - -- - , C'1---<--c,__ .--z__ ,,._ 1 ) ,11 r f, r Name of Mine Forman -~ P , Married or Single _...._-A ,. L , ~ 7 ~ ~ J}. r ,,_-) ~ >?f, v / ~ L -'7 _.,r.\.!. c../. »,_a.. _ , , ~ q ' ( Whalong ;11 employ, of Co., Y. tr1/ / d -?-P>.......o,-~ Condition <>f Life or Oircumsta~c , - -How . . r-u 8 ddress of nearest /tumg Relat1ue, ~ .,.,_ tf_,, _,_e ~ . 7 1 J -2 da Name an (2 ~ _/ =r , -;;:,- -o----:,..,_,__.._-,..._'7 . ,Vas he an efficient man, 7::..v Was he tem}'erate, I (?_.,{~ ~ _ f/4·t r< /~. ./ ,., / l·n whose charge left, d Where an . <{) Y' " , Name of Physician called, if any, ,_ I" , ~ ,._ 1/ ., .,.._ . ' .,.., / 1--~ Name and p, o. Adress of Witnesses. au.-1-·~ Nature and extent of Aooide;J~ .✓,:::? , ~ ~ -;;l -a:.. a-L__e__.~ t" {' ? , 'L <- ~ . r ,.y4 / - r ~ ,.,. "7 _,., r / ~ r 1.:1.1I l1F I, Cause, (Signature) 7 �r.FJE 1''onn l!!:1. UNION PACIFIC COAL CO. - f{El'ONT 0 Mine No. F PERSONA L INJ URY . Name of Person 8up'ts No..................................... a J~LJ9~ ··,·ead,. I ">} ~ "I J 1 .r,/£ • 11f , /J n_.e.... I tc of Ac~, Oa • • .,.....,..-Ip\ ~ =G--- -I~ --Locat1011, . •1tred in t,fine, st e where, If not ff1J Occupatio11, ., Mine Supt. .J,_,,..-. ·················-··············-······· 700 Mine No. L (22.L ___,.£, Nameo; __::_:_,=.,-; \ 0 _/ Age of Person :;jured, _::-(J' -~ What Family, '1 any, ./J / long in employ, of Oo., -?->-~ £' - : ::, and address of nearest liuing Relatiue, Name of Physioian ea/led, if any, 7 • ,T 1me Name of Mine Forman, /) . 17 z-_' ~ ~ ~, · Married or 8i11gle • .. . . 1 Oond,t,on of Life or O,rcumstances, ~~ Was he an efficient man, ~ ,_ . Where and in whose charg~ left, £~~ /,/.,£ f-~ Was he temperate, J-cA.- ~ / y-., / P' / ~ Q ~--a/.¾ 12..,,..._£// ? ~ 3/. / ~ . . 1 ~ . 1 / {I Name and p, o. Adress of Witnesses. l I J I J I ' I (Signature) c.,.•._,_ ~ -·Gil. 7 �STATEMENTS OF WITNESSES. If ,. I· I i, I I 11/ ' lli I !. I 1, Ii \ \1 I \I r . I; I I ·'- I i #i ' //!I �,T 1fl£ 0.NIOn l~orm 12.1. pACIFIC COAL co. ---·- -- - • ◄ pBRSONAL I NJURY. •r10RT OF Mine No. . J Jl> -···················-······ 8up'ts No · ·······························----· l :_u J c5[~ • • ,-ed, ,.; Person m]lt t1nme o, ~ - - ~ <>atio/I, 'x occup Accident .,...,.-J --~ oata ~! Locat1011, C. {l, ,;2, ,dJ ____,.,_.._ I 190 y- ~~~ ,,J..dj'a ---1~-«-- Mine No. / Time / -v- :.c__--L_ 0 Entry No ~~:. e state wffere, . . . Age of Person ~11JU1ed, , )J;. J /./- - ~ . ~/ Name of Mine Forman ~ ~ ' j • _;;,/ ~ Married or Single . ._ ~ ) • l_T:::-~~ ~ ~ 1 ° w11at family, if any, .. 0nd'tton of Life or Circumstances H long in employ, of Co.' ,3 ow d address of. nearest living elatiue, a...-,...__,.co-v, (L ~ _ 7 , --~ _ : . . ,. . _ ~ Name an (}A - - / '--- (7 - ~ ~ / c::::rr. was he an efficient man, t1, ~ p7 Was he temperate, fl_/ ~ , and in whose charge left, ~ , ~ -.:../4.c.,,,/ ~ , 11 h,,1ere ,1 Physician called, if any, Name 0'I Name and p, I..Y 7 Room No. / J'--·"' · X, @ L ~~ 1 ,; r,fine Supt. Name 01 ' 1/ • • ,iill'ed 111 111111 ' If not tn1 _/2. ~ ~ "\' c7. A _ l I • o. Adress of Witnesses. Nature and extent of Accident, ~ ~~ ~ - -,<- ¥ ~ _L,- ~~ 7 ~~ ~ c r _.R--~ Cause, (Signature) 1 J .-2/r?~ Title, >?/. if I �1't 12,6" ON PACIFIC COAL CO. ffJE UNl - - Mine No. ........................................ ,T,'osONAL INJURY. J?BPORT OF P.1:..1t 8up'ts No.................................... ~~ rL~~~r Q "--1::: / / - ./'(- ..._ • • ,d ,; Person ll1jllle;,--;) Name o,. l /~ . ·/ ( occupation, . ,.7_ ,1,-b./• ,; Accufe11t, /~ Date~, /c/ . ~-.. L - -· - r.. 1 ✓ locat1011, / ,·e () . . , din Mine, state w ,e , If not 1111uie ,_J.e / / o ·--t:.. "1 . »(, . 190 ,;- Time Entry No. Room No. 7 ~- Mme No. / 1 1 Supt. G' 1 Mine O --< -.>-\... • • • -"-z_,/ ~./~,,; v/a_..,. - ~ I -r.r '- - - / '/ ~ ·-; ~ . Name of Mine Forman, J,,...,_1,.,/ , 2 : )· , . ,__,,;c -~ 1, Married or 81119/e d__,__ ,,,.. J -'!., Name,; Person II/JUI • • •ed, r :J JI 0'f-c- - - ~ Ageo, . ~ 1 ~ nily if any, Whatlong ral ,n • emp ' 1oy, 01 (Jo., / d a ~ . ..--Oondition of Life or~iro»stances, 'J H How nd address of nearest living Relpue, - -~ --.....- ~ , ·' J ; : : f - ~ ~ Name \ Was he fefnperate., I 1 Was hea an efficient man, din whose charge left, ~ Where an . i..._.,.--, /;)L.. = --?--.>-t.._ ,; Physician called, if any, , Name o, µ Name and P• O• // ~c:,--;,1,.. , Adress of Witnesses. d.j___L,, -=-44 Nature and extent of Accident,L f a .f / I (Signature) 1 JJt aQ~. Title, ~ ' »t-t- ~ I: �'fflr; UNI Form 1~3. oN PACIFIC COAL CO. __ Mine No. F PERSONAL INJURY. REPORT 0 V . • ,,e,~~L/ ,, Perso11 lfl/..u Nameo1 ~ C? /,~ ~ --.rL..__....,.../~ L..{' £_-2 . -rr.-li ~ ~~ f ~ _;;* oacupatiol1, te of Aooide11t, oa . ;ti- _._,,,~ \ . . 790 if Time - : , , ~Mme No. ~--e l- ~ .. , din Mine, state wI1ere, If not ul)toe O ~ Cf)--;:;>1J 0.rf;~~ -p,1 ' . . . ~------ Name of Mine ~u~t: Age of Person ~nJUJed, What family, if any, J _ h '- r 8up'fa No. //,: ,.2 0 Entry No. ____ ' j ~, q ~ • ...r / ( • R,oom No. --_- -- ~ , _:__ ----e..-_ - ..-, / P1, 0 0 ~ 1 of Life or Oircumstances, ~ ~ ._ L • _ "Y _ Name an ~ Vias he an efficient man, / ' - - -Where and in whose charge left, ······----· ....................... ~~~~~~f~ Name c(f Mine Forman, ~ Married or if;(g,e , d ~ How long in employ, of Oo.' -~ -~ d address of nearest /1uing Relat,ue, Name of Physician called, if any, , ····---·--···· 1, Was he temperate, . l_::;', ~../ / ' - ~~:..--:7'7-1~~_,,.__.,..,_~ l, f ---P' 1 ~~~ ,~~ ~ _ _ , . , , __,. /; , f I, . ( • - •-~ I 1, f I ;JI Name and P. o. Adress of Witnesses. 1 I i1 NatureandextentofAccident, X/-c ---'l-/ - ~/---;,f,~ ~ ~ (~ ! ~ ~ b< Cause, (Signature) 7 '/ �STATEMENTS OF WITNESSES. �tJsroN 6 1rJ PACIFIC COAL CO. _ Mine No. - --;;NAL INJURY. R~J•J'ORT ) OF pJSRS ?-,1( t / 'Z 11ame of , /1,,atioll, - ~ - - < <?..----t. L.../4-' < • • (5)--c,e.::;_. -S __. __,.~~ / ~ - -c / . ,.,1 .- <~ If ,,at injured Ill I " Supt. ' (la/lie of !,,me •• • d e of Person mjlO e ' ~ :;, Mine No. A / / 9' .--t? , c__e__~ Entry No. •t if any, What faml• y,employ, 01,.; Oo·' ? .._ / --- (7 -· ~ J, O u.~ Wa d • whose charge left, Where an 111 d ;.; y (lame 01,1 Physician ca/le , '1 an . ' - ~ - -v . / / J - - , .~ ~-- -- ~ J, /:) _.// Was he temperate, 0 4{' , ( <;,___.Y~ ✓--- Y ......... L ).,-u / ( , {, / / ~ ,.,J, _.-.- .. . ..:5 __,_.,-e_e ~ / Oond1t1on of Life or Oiroumstanoes ' . ~ ., Holl/ /ongdm ddress of nearest liuing R:l?t,ue, Name , t man, sheanan aejjic1e11 / ._ / -- (---;;:, ~ ingle / ~7' Roon No. J.7 / / / ,.1 @ ~ Name of Mine Forman, ~ __ _,,,, :I '7 : ~ -~ .....-<2.-----'" Married o Ag Name and P• O• 790 .I-/- Time Y ,,,.c~ o,te of Acctd•;;~ ~--=------Loaatio11, / . fl?' ie state where, "' / ·······················•. .········v 8up'ts No..................................... • •d person inJUJ!!_ ' occl I 128 / __..ee 9 ---....._ r2~.., / - ·- . ...,.,/ - --,,_~ _ A . - - \ Adress of Witnesses. Nature and extent of Accid~ j r Cause, ~~ . ' /11 ' lI ~ (' I\ t I I ' I I 'I ' ' I (Signature) 1 I �STATEMENTS OF WITNESSES. �•.... ? roN PACIFIC COAL co. 1·1J6 tJN --· OF pERSONAL INJURY. Mine No. RJJf'ORT Bup'ts No. J. ~ ·························-······ ,; person i11jured, Name 01_ occupat1011, ,7 . / oate of Acc1<)de1 ,---.--}7 , ,:z_ 9 ~ . 790 ij- Time ~ .-M //-30 <? h[, Location, ~ ine No. 9 . iiiired /1/ Mine, stat where, / Entry No. ~ Room No. If not ,,1; • • -) ~/, /:' r!JfMine $afJt. ro-~ ?" _:;I vName of Mine Forman Name O . . ,:2.. ,.s- '--~..a---~ of Person .m1ure "':1-- - ~e._ ~ "t/ Married, ors· 1 Age What family, if any, mg e How tong in employ, of Oo., Oondition of l. . Name and address of nearest living Relative, ~~ or O,ro,umstanoes, /?1~ aJ ,. ~~ ~~~ Was he an efficient ma11, Where and in whose charge left, Name of Physiaian called, if a11y, ~-~ ,( Le v' Cj? AL,/ 4>4 -r,,,~t:i~Was r,__-:: : :;:-<-- I I - - J , , d ~ ~~ ..,_;__.t:::=--f erate, . Name and P. 0. Adress of Witnesses. Nature and extent of Acci~ , / vn-~ -~ , \, ' \ Oause, \) ; I Ir I I i• 1: I I / I I ',, 1 �STATEMENTS OF 'WITNESSES. . ,. •..t,., . t .. I. , 1 r .,. p} LlCF: •• (! .. l 1,:,.1, .... . .. ' . ' • f ' •· ..,,,. • I • \'Ol" ' 1 ( , ' l •• th~ m11 utn r; t' tt...c (Jn thf b, &t1,i "(I •.J . J,' < tHf' •·· d r,J n dc:wn cnoi.;;~b ,,f . •• ·1 • .ht 1 t. ,. n• ,.. a:; f'v r a.1 t, ri0 dt,n- t.iottom .. 1 mnt 1):1 up a littlt -. . ♦ ~ r. 1 r'\ r ,. '' t . .. ,. '· .t • . . .. ,... 1 �STATEMENTS OF \VITNESSES. \ • .l cl • ngcl' J . ' })Ut Ufl iJu1,1· e • 1 !'I,.·. 11 ••·.','C" . •q /' } 1"•',; j ,-l'.,al • • 1.(4. l :- v:1 • : '1Ect 1.' (', Cu h•~1·1: :-id ~ .,\ i' . i. . .. • ,. fl ti\:- ) ( . .d •. 0 1,1. I I ' I .. , .. :f -,r.,, ... ! ' \ # \,; • ribn ~p: ·:,. 1 1.• ! I ~ .o; .f l. r- ?-t 1. .. r .•. t · r, •• 1,..1, t ... 117i ;-, , rm.. :1.: co :•t.b'\ c· ff• , r, • ... un~: , ,,, . r t, .... . i.~ 1 ..•:"'!") ,1<., t ~-·', . r· I r,.... - ,.,, .1· -.. '1 8 ., .. 9. ,, i;. C"t:'0 'l .] r, r ..... ,.. . p ., ' l. .' f"'. ... .0 pnan ~. i· , E •' j ;! C• ~•·' <.( . t.: t", r·r·!. i1 • 1' b ,,. \ ,., -· "' t r•f CJl .• ' 1 to ;.•.\ . -e .~ r,~ .-.. ~--,··:- · - ~ I �Funn 12:1. • FIC COAL CO. T-:' UNION pACl • r rt n ,Rb'f'ON Mine No ........... --- 'RSONAL INJURY. T OF PE~ 8up'ts No··-···· /7~)Na--~ if person injured,. Name o . } Jl L u_.,L,,.' L [tc occupat1011, ,i. (..,A.-J ,iL,.J, I 7 ,. ., Accident, (..,{, oatc ~1 (3(.,,._,.._v<--~-c.. L c~-<-A-,.{____, Locat1011, d . Mine state where, If not injure 111 A- 790 '-/ Mine No. 1. U' I 1• :, Entry No.Ljdc Name of Mine Forman,_ f 77,,,,L ,, . i . Ma71ed or 8111g/e ~ .Lo Room No. 6 - t:, Y ../ _/_ ,: _ C;;f-1 a . . q _ _ ~ ~~ V VIhere and in whose cha ~ eft, J...--,r..J)-H ~ ~ -z- c....- 'L ~ - Name of Physician ca/led, if any, . ~ -l..--c.-<..-J - O U Name and P. O. Adress of Witnesses. Nature and extent of Accident, 1 a. 2.u_ '7.. tJ - e rp/oy, of Co., ~ 0ondit,on of ~ L e or · 0iroumstanoes, How long 11 · · R I t. /> /J ,1 ' I, _ t;::' J 1 ddress of nearest /Jurng ea we, ~ 4--<-L.V ~ u(9T/,.. _/ d Name an a ~ ,,.....,.-z ~ """\....; was he an efficient man, ~ ~ J/... Was he temperate, ~ Whatfamt·,if'}'hy, ' CJ CJ Q ~A" e s.upt. · .-µ,,tA-C--tJ /1!,,t_c..t:Jt- 1/ u.-<...<..-<._ Name of ti m ,,_.,,:2 l Age of Person ~n1ur. d, ....--- a:,:i, 9 / Time J 11 CJ ~ ~ .,_ ~ ~ 7 ~ C a..e..e., ' /;- If , a L(' =-----·'' t, I n. -~- . .,. '• • ., I r. II I I ,, (Signature) 7 Title, ~ �STATEMENTS OF WITNESSES. Kine 110 a c:umberland, Wyoming, ·JU~ 21, 1904 loyed cit atn~s, workiag 1n mne no 1 ■1a,1::....w-.1>workiD1 in 5th north entry No 3 !lirn~. ~.. re~ ~1th Antont I 414 not soo ,l1Ja Whon he was Jmrt but .... . "• lvr,, a of tb ro .._ in.1tU" d, I cll!!lo down.from the faee of tho ro• , • tleo ot ooal hd fallen ott of the rib knooktns h1a ,...-.i.a. • ~ ,- ,• about 150 toot away from hill. a.,gastl' ~ fi&r Ct"itt1ng hlo 11 ttlo ti~er on. hlo righi hand, (Sgd) Plulip HUonl"o I, ,,. I' . I I --- ": //ature arr �,A ~-·!J i: j;~·1 ,) er no a 1:-- L Antont fj;':l 11t ... 1 1 -,.,. iag h1a I I C tlner, arr mr.ployed at tins 1.00 ?. ~•or\d ne; • ar➔ , 5tl 1;ortll ont.ry. r 1. !'l car of coal at t he hot to,r . f r,y rcom ft"o~ the ., l n :r t en Jul~/ "lt.t at e.ho•1t 8 o'clock \ I t c or co· l fell off froir. the north rib of my room t e t P. , !Itrikin-:; ,,.e an:1. k noc1, i ng me c s,aJ ns t t ne car' C tttn th little finBer on my ri~ht rondo (signed) �li'or1n 12.1. ION PACIFI C COAL CO. ras UN _____ p/WORT • OF PERSONAL I NJURY. ,.; Person injured, t✓ameo1 _ ~~ ?1-iv~ occupat1011, 9. ~ oate of Accident, c;/-z.,{,&y .7 I Looatio11, lf CA.-A--<- o{ . . ,·ed in Mil/I', state where, If not 111)!1 v7A.'/} .,r~ - 190 Mine No. 'I Time < f : Oo ~ Entry No. :J- JJ(/}-~ Room No. "-....5 (; ~ IL {,,zt ~ . J L c_d_~ Name of Mine Formar, J n J. Name o1 Mine Supt. .-.;. ~ 1 V ~ . ' ~{, ~ Age of Perso n1ur d, ~ _ U. . , Marr ed r i, gle ,l'h, ~ ci, What Fam 1y, if Y, -v- 3 cld ~ How long i ploy, of O ·, -t.?v-zJ v tt,.,u._ t_~ ~ndition of Life or Oiroumstances, Name and address of nearest iuing Relative, C!--f! ~ o(_, was he a11 efficient man, Was he temperate, &-e...-o Where a11d ill whose char e I !ft, J/lr. Name of Physician called, if any, ~ J o ~ *f cL ~r 0 Name and P. a. Adress of Witnesses. F Nature and extent ~f Aocident, L~ 9~ci:--: ~ ~&C a,,_~ ,__ =-c._~ Cause, : II I (Signature) 7 �STATEMENTS OF WITNESSES. ( ' 1 I I I •1i I ' I I ,·· ' I ,. �Form 12.1. NION PACIFIC COAL CO. 1£JB tJ1 ] Mine No. - --- - F pB'RSONAL INJURY. p11roRT o ······························ L ... 8up'ts No..................................... -~ person injured, Name o, ~6 .11_ 9---' 2] C -H ' ~ n occupation, - ~ , r ~ t .,,.,/1_,,,,,_Q 3 rr:f 190 .1.../ Time 7 ,' ] o teoJAcat ~ , / Oa . Mine No. '7 Entry No. tocat1011, ,n _ ~ 1 . . ·ed in Minr, state w ,ere ~ If not ul}ur ""' ---. ~ Room No. ~ ~ J a_ Mine Supt~,l/(,) J{ c,_J< Name of Mine Forman . . ..J <_ , ~ / Age of Person ~111ured, ------"'I Married or 'f!.:~ p ~ ~ What Family, if any, ~ 0 H long in employ, of Oo. ~ ndit10n of Life or Oircumstances, ow d address of nearest living Relative, ~ d. ~ CJ/7_ _ ' _ Name an ~ / r ~ was he an efficient man, _ _ , Was he tempera~e, ~ Where and in whose charge et, ~ q ~ )../-~11:J-e_ Name of Physician called, i any, ~ ~ <?(___-., tf7 1 f/(1/110 0 tf.ao . . 1 fH. I Name and p, o. Adress of Witnesses. I I ~ oU Nature and extent of Accident, (_ (Signature) Date 1 Title, ~·~ �STATEMENTS OF \VITNESSES. )(° j �I . uame and p, } >t , ,,.. ·1 tr t1 Rature and / ,_____ J I /1,e, I I. R.. ~!. Cause, ., ~ 9 ~'l c4._ l-c.<.., ~ ~- z ~ Jr '). �Form 123. ff~ vNf f O~ PA crFIC COAL co. __ __ -·T,'RSONAL INJURY. :pVNT oF pµ \: /?•l ,,. · · 'ed y ~~~, person 111)111 , ()(_ //11111eof )1~ oco11Pation, . ., Acoid¢'Jfl g ,rO\ 190 1/ Time ,A /~z-c; ;( where, Mi1111, 0,11c ~1 i~c11t1011,_ . ., tj not ;,y111 ,, Mine No. / e / I D-t- ,, Entry No /- -----• «:> Room No. /3 Mine Supt. '/ ,yzor Name of Mine Forman, • d 3a 11n . ' of Person i111ure , ~ , arned or Single }?-? ~ , 8 Ag • •'any -:-Ia<_, What fanuly, IJ , (],1 ·, n,,.,..,, -· , ~ tong in employ, of Co.' '~~ _7 Yf./o,,--r. OoQ!!jtio~n °1 Life or Circumstances, Hoiu ddress of nearest humg Relatwe, • ~ o( Name and a Was he an efficient man, '--> /J,-.1.,,. ~ 'i! ± - t Was he t e m p e r a t e , ~ ~ , nd in whose char . f/1/d ' §J I ~ ( C(.--L, Cy I a ~ ., Physician called, rt any, CJ ~ I d ~ ~ /tame 01 1 m1111CO 2 ~1 l ic I Name an d P• O• Adress of Witnesses. f',. I ,, :,; I ~lo-z.-.<-L ) '/z:,-L/4 a ----. I ' r • ' I· 1/ 'I I I 1 • • -1 I Nature and extent of Accident, / ~ Le <,{_ /:;C,_,,_{ ~ 4 t (Signature) 1 Title, '' '' .\ /' , l �STATEMENTS OF \VITNESSES. �Form 123. ON p ;\.CJFIC COAL CO. ' ras vr-n .-- - -. Mine No. ,. pERSONAI✓ INJURY. Rll'f'ON1 01 ....... ........ .......... . t (f2 tt, ~r Nature and extent of Aaoident, 8up'ts No C2-d- 0d~ o(. ~ a . - 1 ! ~ () , ··················-·-·•······-······ ~J I lI ~ , ~ <2-<..-<- oL 0 - ~ &,-.,,,_, z I !• 11 (Signature) 7 Title, �STATEMENTS OF WITNESSES. (~; --.....J--L-...J-~ ~ ~~ ~~ �,rI-IE UN ---- 1:15 ~: Fol'ln 123. roN p ACIFIC COAL co. __ Mine No. ............................. ~ , OF pBRSONAL IN]UR Y. J?EPOI? 7 8up'ts No. _...... .. ...................... -< Age of Pers~on·,,p(r 'd, ~ <"Y2-<-.. ~ 3 What Famiy, if a Y, =< • How tong in mploy, of Oo.' iw-v ~ Name and address of nearest liuing Relatiue, • a..........<, ~ U Was he an efficient man, Where and in whose cha1y left, ~ er~ (l Name and P. 0. Adress of Witnesses. ?rz.-~ - Oondition of Life or Oircumstances o( ~ ' Was he temperate, ~ ) ~~ (j ~ F-1-/- Nameof Physioian ca/le , ifany, i Name of Mine Forman, ? / /. A ~~ Married or Wig!~ ~ ~_ ~<--<- , '.\' /:; ,' 3 o ,/2..,p--YI Entry No.f f't,_,A.'-u., ;oom No. Time Name of Mine Supt. I · hr~ u ~ , r /- r fl~ ~ ' I 1' , Nature and extent of Accident, ~~ ~ 8,_.~ cl., (Signature) 7 Title, If- ~ o(___. �STATEMENTS OF WITNESSES. I , I ,; ,/ ".~ (.. .I. ;. , _I,,!? ,, . I I ,, o1 (/ ( , ,t. '' IJ) ~ , ... .,,., ,.., z • / \ . I' ~ • ' I i..... ..I" I I .' v //. ; · ,1.{ .-. .I I . I t I \.' I • /. L. • l /' ,f,,--/.. :-~- l-;1 : ~ I ! / . I •, -l; r ., .. I ' , \.:.;_)' ' , "t' I ' ' ,.,. I>. : ..._ -. I~ I I ,' , I .. / ,I • • '. ,· f I I ! I, ,\ I II I j I ., I !. ! ; r .. f . •.,. - .. I .. , _ ,___ : ,., . <- I ·~-··' .,, I .,,. : . l ~-·\ / f••I ' '~ ..,/ I /· t I '' I I �Form l:!-1. PACIFIC COAL CO. rJJB oNJON - - ---- ,1 U Mine No. ,1,•T.>soNAL INJURY. OF Poi"- ························ · · · · · · · ~ p6f'ORT P•"'" i11jured, f/tll11C of ~ - occll/J~;;:~- , M ~ )11 a--il I!. 'ffl ~f /f/7. e.-<.-<.-/ I O _ f,{ 4J.J-/~LA---t:r Location, . 6' state l 1ere, .. ,red m R,mc, If not 111}1 -t? OClfoOJ f Mine Supt. • . 7901/ Mme No. ~ •. ;f/3_,e._o-c-A_ f Person f/lJUle ·1 ;~ any, I - Time ~ ,- ~ £11 t ry Name of Mine Forman, ••. d {IClme O Age o 8up'ts No. N~~ t-<... Room No.a/ 3 / &.V;~~ a. / o.J} What famr Y, 1 -1. A . . . in employ, of (Jo.' • l/\) ;B~Ooncht,on of life or Oircumstances g I HoLU on • 1/1,,,~ ~' ddress of nearest /iu 11 Relat,ue, l'f/{ J;f"7t V\/' Name and a was he an efficient man, nd in whose charg I ft, Where a . , ~ 1 l ~ 00 M . amed or Sing, e 2j/:. ,. , •••••••••••••••••·················.. , 1!:!_s he temperate, ~ ) ~ z..,t/'l ~ k1 ., ~ ~ ~, 0 0"/JY ,/4 -<-p (J Adress of Witnesses. /fame and P• O• Nature and extent of Accident, L Ii;,,,_,, r r j J--,,u' I?. ' "-<-< cl j • '1,,V J I I I ; ,,)·· I }) JJ' I' I I ' (Signature) 7 Title, �STATEMENTS th1& ~ccid€:nt t o 11ry he.net would soy.., t !1e J.(, t h . 1 of OF WITNESSES. On the g f n.Jm , afternoon of Tueolte.y .r -r1:w ri,e.rki:ng !Ji.akQ·ta for ·tbe :feooe then boing At1erJ.12-t • I tbi11lt 1 t wr,~ bot1.'!ecn G o.ntl JS o'clock that my left hand ntiJ;a ~liP!1od :tn EHJ:!10 mc.~110r ar.,J the two znid~lo finger~ ,, ~ ..,r:.1, -. .::- 1.1--;:...,...,,., ~·-" ll,, '1.." .'i-H.., •:. ••\·1.·. ' <7...., ~• • u..!,o,., ... ·? J . of my le.ft hand were •1.'\,.·• c·• ,-1,::.-,e~ ·• .,.. ,I,. J:- ....r - ,.,,,. w~u' "-'•... l<\t. 0 t :·('l> J. e.l ose t· o t,., , 11!-G ~aoond ".;0111t r dQ:n't 1~mv i f thc :ce, were e.ny witnee&ies ... I u0..s not loo!ti:ng for al'lY wi t :t1e::-:aes about. tha;li t:l::1io .. )Signed) Copy . W. :a.. Con:.rJ:r �Form 123. 3 J:c; 1§2 t. o. ................................... ... I N pACIFIC COAL CO. t:" ffJD vsroJ. Mine N - -r,<RSQNAL INJURY. • OF p O \'. 1 r.•pOR J?i:, 1 ····················-··········• \ l/!!13 ~ person injured, //{I/Ile O . 8up'ts No. 1 ~ (;, v v f 1 , , , , ~ t1 I l oact1/lat1ont,.w t (},v<--aU - 790 L/ Time oate o_f AcCI ' , ,1 ,-~ ~ / . , A . / C . r a Mine No. • n "/'n 1Loclltl~ '. , / . Minr., sta el 1ere, ~~ ~ , t 111}Lf/Cl /II If no 4 : I 6 - ( } Jzz E11 t N0 (!_ c..__,,..-. ry ~ R o . o m No. I Mine Supt. ~ t-;2,-e Name o1 , Age OJ,; Person .injured,j; J Name of Mine Form an, a_ _ rr-<---<--_,__.'--"-• ~ Mamed or 8 gle ~ C2_J ,. __• / ,__ / r '-· - - -----c_ O"\..; . (-:___ ond6{7~ lifefr°2Jir u stances C-<--e-4 110 ; Vlhat family, if any, -~ in employ, o Oo.,~ 3 ~ HotU Iong . . • d address of nearest !1u111g Re we, ,__..-"'--.., J Name an ~ he an efficient man, w~:re and ;11 whose char eft, Ylr'-;(--v C/ ) . • Name of p11ysiaia11 ea/led, if any, V:;1-·~ f}:;: ~ ~~ UI\ c./? t1 Was he temperate, /-.7~( ~ -. ~ o,(__ ' ffe-, U .j !Jame and P• O• Adress o1 Witnesses. Nature and extent of Accident, ,:,_,/.. 3 n-_i:f c;t-:r•,L f t t{ (;,! ( :;---(/ (, / / Oause, ! (Signature) Date 1 Title, I �STATEMENTS OF WITNESSES. �1-'orm 123. PACIFIC COAL CO. flf6 ON ION - ----- Mine No. ••••••••••••••••••••·•·········· OF PERSONAL INJURY. p,sf'ORT 8up'ts No. ••••••••••••••••••••••••••••••••••• 7BOL/ Time ; J_!!_ p ~ IO Entry No. V Room No. Mine No. Name and p, o. Adress of Witnesses. NatureandextentofAocident,~ /::;.c, ~ ~r J~oU . I I ~ ,<_ ~<__ !1 \, II 1 1' Cause, /1 I!,, I l (Signature) 7 Title, ·- �• • ~: . ; -• ... ~ ...; ... ·• ~ \ . . \ ·. ~ . . . ~ t .; -I' /.l ··' / :;:re I r,r,:, ( •I ,:"( , , . ~ .A ~ ,, / , ., f' " . .... ..... ~ ... • .... ) . ·" C .. ~~ }Jfj-44,_(J,u... • ~--~~ . �Form 12a. ON p ACIFIC COAL CO. 'flID oNI - .-,rr.>SONAL INJURY. T OF p i;;.1.-.. o. ••••······························· .. RsroR 8up'ts No 1,90 M• -Y Time me No. - - Loaation, • t •niured in Mme, s J /lot If l '? " t:_ _ . ~ "'--<!_./ft-. 0 l 4---/] 3 o1 Mine Supt. Person injured, I Age o1 . '\(,. Name ~ _ _ _-...., ~v- . /lame of Physician ca/le t' Ent, ~ N0 -:.,. ~ ~ / Y--: Room Pio. C::-<--l.----7---..,..--c.. ~ , ~ Married or Single .,-:::} ~ . ·_ , ;J ow • d ddress of near 1•umg e a we, . ' name an a i. • Was/Jean efficient man, /J I Where and in whose charge 1eft, J...J • - , C2..---'J1--~'-- ~ '\I ~ f '] {) ~ /i) Y 7 ~~ •~ ~, 0011dition ~ R I t' 1-'i\ '···································· Name of Mine Forman 0 'f If/lat family, if any, ~ .,l H long in employ, of (Jo.' Name and p, 1:3 Mine N 'f any, ..__, ° ifi~Circumstances, Was he temperate, ~ 1.--,__...-,._(},---"< v( "> '-L9-o I I • I ' U o. Adress of Witnesses. t(/ I ' l4i/, Nature and extent of Accident, /1 I Ii I .( ,, .I I (Signature) 7 Title, �STATEMENTS OF WITNESSES. I f} ~CV r ~~J ;f{lh ecvJ ~ : ~ ~J _<M--, fl Q . R _ . ~ f).A /{/"- If:;/ T ~ ~)l_ LL ,n,c/~1~y / ; ,_~ oA I 7 (h-,;-,,,,.,,J ' J_ ~, ~ , 1~ L~ , ~ :;fl;, , ;,/,;,)~if lb, ')£_,, //4A-V,-U ~ ') (Y , , _ ~ ~ ti_,, ~ ~(_J , , Jj_ ~ =- {'o"Jf/~ ,Wn,,o r CW /Ve! t,~ ~t:-uvl L !L-LJ_ , ~ u ~~ Cl-~ r ~-~ rs51 ol ) ta e ~ ~ . >1-13 Wcu.. r J ~~ J-a~ ~ r. zL ~ 0-0~~ ~/2J;_ ~ .- ~ (p /,/_~ ,,.L CV a2Jf I , S?_~ /;, - o_L/ CL-,---&(/ ;, ~ a.,µ, 1 tL ~ ~ ~~ ~ ~~ ?_~ - ~ d~ ~ A {fr-! ~ c - , - , , ; ( &A~ ; �1rrB UNION pACIFIC COAL CO. _ __ , F pJSRSONAL INJURY. J?TSpOR1 0 8up'ts No. ,; person- injured, {Ih C- o.A...J )/J~ ('lame o, , ;,. ~ 'f' • J ~ occll/Jat1011, oate of Accident, a t.,,c_r,./4,-<L,,_(. -2 l •r{ t,l..,. 1' Location, 7f~L/Vfj ~ . . red in Mine, state where, If not Ill} II 790 Mine No. 11 ~ 7 Time I Entry No. Name of Mille Forman uamc of Mine Supt. {:•. / J ,; Person 1111ured, 91/ Ageo, ·1 A - / ~ 0 ,., -fa i-e. Room No . /c../2 Mar & r Single 7 n 1. ~ c,(__, What Family, if any, v v /'11 /; . . Hotu tong in employ, of Oo., . - ~ ~ Oond1t1011 of Life or Oircumstances, ddress of nearest /1u111g Relat1u ~ Name and a <k. - j - / ~~ fl was he an efficient man, Was he temperate, !'1~f Where and in whose cha1 ge left, , '(J_.,,1 f-C-<.- '- ·<-- .____•.._ ~ c ~ 9- ; Name of Physician called, if af0, Name and p, o. Adress of Witnesses. 0• 0 0 L- - ~ ~~ Nature and extent of Accident, J, (Signature) 7 Title, r--- ~l-c ~ ��• Form 123. roN PACIFIC COAL co. rfJ6 UN - -F ph,"RSONAL INJURY. RlwoRT 0 8up'ts No. .JL ; ( ~ ., person i1ifured, -~ occupat1011, 1/;f- I I/ 1 Accident, t 0 I 00 Ii .'J ~~~ Location, I ._ . . . d in Mine, state w wre, If not Ill}uI e t✓ame o,_ 1901/ Mine No. I Time L/ ,' o d I Entry No. pz,,.J,._,_ Name of Mine Forman, .. I n7• Supt - ~~ Name of ,,me./ ::? q ,f Pers 1nn1un • / Age o, . ~ What Fa ily, if y, ~ (!2,(J./ H long • ploy, of Oo.' N::e and address of neares~t liuing Relatiue, was he an efficient man, V/here and in whose oharg~ /J nature and extent of Accident, cY / 7" C):i,z~-~ fi::-~0ndttton of Life or Oircumstanoes .. 'tJj--- ~ ...._ J.F"~ y - a Name and p, o. Adress of Witnesses. Room No. )/K ~ a-d ~ Mar ed r Single t, OUAA-< ~ o l Name of Physician called, if any, o~. h_ a/;.. --.t> C r~ J fjLI JJ , Was he temperate, Y'--<-<, ~ ~ -,__ ,_ ... f/- ~ ~~ ,,,(____ @7 \ (Signature) 7 i Title, l1 �STATEMENTS OF \VITNESSES. '.. �Form 12a. ~ pACIFIC COAL CO. rf!E uN[O -· -, p[SRSONAL INJURY. 1 Mine No. .... ··················-··· /'['ONT Ol 1n 8up'ts No. Y3 ~ j;;::z; ' u occ11Patio1C\ 0,.~A/ 6 - u.., 790 1/ Time 7: : l o ~ Mine No. oate ~f Acct~-; :J_,~Z-A-y-7 Entry No. / 1 11 Locat ~ •. d • Min<', state n,,t,ere, O 111ure //1 'lw ., parson t/4red, Nalll<J o, 1/"~:· A Jf 110t/ ~ .. - ••••• ••••····················· a - ~ Room No. J' )"' ~ ~ f,1ine Supt.~ •~J<. Name of Mine Forman, , I 11a111e o1 ' o L./ • C<-<Y ,; person injured, ,:, / / Married or Single )~ ~ ~ d Age OJ . 1 A ~ -I- J-../ -- - ~ ' " ' What Family, if any, r - fl - b , ~ JL ~ .. Oondition of life or Oircumstances ~ /•11 e1nploy, of Oo., ~ r • ~ How Iong +ffHfH:HK, • ) n / • / ;t Name and address of nea.J ;t4rest living ReJe:ti&e, • .._,..._ c,(_ u •S f-~ :__, , ~~ , :r-1 _A ,; f; Was he an efficient man, • ; in whose char e eft, ),4~ Where a/Id . ,; Physician called, if any, flame O~ flame and P• O• , ,.(L.A_~ ) ~ u / C, ·-- c(_ _Was he temperate, ~ ~__,,(-c-. 0 (j / -- - ~ () Adress of Witnesses. Nqtun and extent of Aooident, 1 J -:t" ,- 3 ••, ,,,. qv I l T / < o(_ c-(, ' i ' !J I' i ) J; ~ j I{ I l;u. ,: :II 1· \! \ I 1 Cause, ~r u a__ o(__ CC- ~ ~ -~ J I ~ ~ ~ tl_._ TI ~ ~ cn-e-..-- 2~ ~ ~~ f -tz ~ ~ ~ (1 r-1--<_'/4_ ~ [_s, ~ ) {J (Signature) 1 Title, Cbeo ~ G ~ Ck../ ~ ~o-y--- ~ OU. o,(___ ~~ • ~ ~~ ;, c.j rJ ~ !) ti.__.._.,. ~ e ~ 12_ C<.-'L/ '1 / r cr-- ~~ £&a.4 ~. 7( I I �STATEMENTS OF WITNESSES. 'l t:... I I �1'.T ffl E vNT0 n P ACIFIC COAL -- Forin lll:l, co. - Mine No. ,, OF' PERSON AL INJURY. R,wo1\r Sup'ts No...................................... . CJ~ /llR. h /.-, , p,rson i1,j11rqd, c,,...-J 0 11amc 'J. ) /r 1/l.. ~ occupat1011, . ~ oatc of Acc1de11t, lv - C,(__.~ L0catioll, {!1.,,~ . . d in Mint', state where, I/ not ul}ure 1 7 190 Mine No. L/ Time < / :2 '. ]u Entry No. 1./ .S /J~ ~~ ~J_ Room No. Mine Supt. i::<~r.A _.,<_..t.,..<J u-< • A.-Name of Mine Forman, _ ;J Nameo,f 9 Q_ ~ ,1 Person • uur 'd, o Married or i yle ~ .s..,-e_ Agco, . ___.... 0 What family if a Y, ~ long in employ, of Oo., Cond1t10n of Life or Oircumstances, How d address of nearest living Relative, e.;l!_e,,-_..._o,(_, lA.r--v~ Namean Ov Was he an efficient man, _ Was he temperate, lrv-v .. J;;;~ . - Where and in whose charc. eft, ~ . . . . ' l ,1 Physician called, if any, 'Yi V Name 0'J /.?... L,-,4:....<....-C-... ;/~ ~/ Name and p, o. Adress of Witnesses. -r } Y ' . Natur~ and extent of Accident, J., (Signature) 1 Title, �STATEMENTS OF \VITNESSES. �.. .\:., I I • I. ' Ho 9 Jfine Aug 23, l C.: 04 ,. J Accit..:::n t ra: c:: t of Tuk oo P lc..t I u.nd my pL-.r t n e r y10.s l o din c oal Y, i t!l 1 1im in 21 ' r oom 6 entry, 2 lJl a.ne o n the 2 . rd a.u.y of August ab out 7: 30 I \ o'c lock \then 11::: \TUS hurt ·,ti th o. i, i c ce of rock \"Ihich fell .1 < f r om tho r oof . t rt.ck in the. .,,ro 0m and me a.nd my 1>ur t n e r vms loadinr; on t h e 1a,1er t r uck in t he e ti...m.e ro om. I t old him t o sound the roof. ,_,.. o t t he c ur- a.hout lo..: de d l ot d thi:: c · r t.:.nd ~c uft ~r I r. o.id Ho ' .... . ,,. on t:i.1e hcrn.d L.nd l ee;o r~nd a.rl 'J C t...U, ·i-i L i· i m fl311 rock ·s han t h/3 h i m ;::..nd brour;ht him \"!t; t ook the rock of l eg. ri.:ht t..i o broke ovtE- ide of thu mine . . .nd. t·n.-:y t ook hir.t to t hv \"!ye . r;cnert~l I' E o G itul . Thc.H·e \JL'.f! no ono t o b l omo f or th- : c c i de?n t. I t \'JllB a 1 li t! l ~ c nr e l csBn~s n en h i a :a.r t . ( Sed) J ohn Oros a.n •'.\,.I •,' ' l • �Form 123. N PACIFIC COAL CO. tr!E UNIO 1 -·. ---- Mine No. 'I ,r OF pJSRSONAL INJURY. pJi/'01' /) " I JU--/4 14r' l 4,,t-} · I ·················•········ · · · · · ~ ·. 8up'ts No..................................... {J_f t:<_/4 ,.; Perso1Y,mj11red, l.)(. Name o, I • .,.,.,_· t r ?'-,,:,{_;'--.,,-occt1Pat101\!. "-.:... ~ . ,., Aa~z·tR,1t, a_,.__ ..... ff,~ oate o, 1 <.Jh0 ~ 1 Location, , l>C l'Z uf~p,_.,__ Jo . . ,,·eel in Mi/II', statt·where, U ff 110t 11111 790 Mine No, 1/ Time ? 7 / 'd u Entry No. ~ ·l. Room No. Name of Mine Supt. ~ v J/B~-4<-J-<._ ., Person injured, A/ 1 Age 0" . A1/ What Family, if any, • How tong in employ, of Co.' c;z .<?'~ Condition of life o! Circumstances, Name and address of nearest liuing Reft:ltiue, #-{ p--c-A_ ~~ j<7 Was he an efficient man, ~ <was he temperate, Where and in i_ul:ose charr.(!ft, ?/4,---....<J:;;:_ ~ -t_ ) f u-:.-r ~ Name of Phys,a1an called, if any, /-? fl- ~ "'C Name and p, O. Adress of W i t n e s s • ~ ~ ~ /f~ Nature and extent of Accid~; ; - ~ I Ii i• I i\' (Signature) Date 7 Title, �Form 12:1. 0~ PACIFIC COAL CO. rrrB uNr •. p/WORT 0 - . F PERSON A L INJURY. Mine No. .,, •.. ...................................L----'- 8up'ts No. ,; Person injured, (/(1/IIC OJ o·Y' Y('. .~ 146 :·, ·····--·- ······-···········-······ ~ occupation, . t J~/7 Oif Acc1de11, ." oatc l C(l tion, o . • . din f,finr, state w e,•e, If not IIIJU' e ~ ~ + 790 , Mine No. 7 Time ~~ / 1 Entry No. 4:-~ ·, 3 ' ' Ro om No. ~ t:7 3 f::.--o · £ , eof &fine Supt. ~-o-?'(1/' Name of Mine F o r1 m a ~ -r-"~ /,am • • d ~ ,,,L . ' . n(. c ~ m;ure .,,/__., ' Marr, 'ii Single ~ , Age oif Person ;; any ' ,;, __,.~ What family, '1 , /.ld /I -~ ._ .. long in employ, of Co., ✓~ X-o ~ Co11d1t1on of Life or Circumstances '--How d ddress of nearest liuing Relatiue, '?........~ IP. /"Z) ' , =,./ Name an a -~. v ~ , V'~ ~ //' ' Was he an efficient man, ~. ' Was he temperati, ;::¥'°, Where and in whose charge left, ~~ ~ -';,,+-I ' .?/ d S, /R) .Y'/,._..,,_;;tcr--ft'--"-"-<l? , Nameo/ Physician called, if any, 1 /lame and P• O• Adress o1 Witnesses. Nature and extent of Accident, ~ ~, ~~ ~ 1C-...:.. 1 ~ Title, U �STATEMENTS OF vVITNESSES. Stat ement of party in jured . I , Tt;r ik Saari , v;us wor lrine i n Wo .1 Mine a t Rock Springs for U. P. Co&l Co. , a long wi th t1i kko Partane:n . I was mining in the cross cut of room 73 , entry 45 , when a s mall piece of coal flew f rom t he point of tr.e pick and f: t r uck me in t he right eye. There wao no one t o bl ame f or the acci dent . (Signed ) Erik Saar i Witness Thos . Norman 'I I I '\ �..r r116 Form 12:1. PACIFIC COAL CO. V sro1:~ -- - - - J?TiroNT Ah ~(_, .~ ? ~ Time Mine No. / lA fl ✓.lAI j • ·········-········ ······· ~~ 0 o:~. Entry No. tocfltioll, . Min<' state wher , not i11jured 111 , If •••••+ • ,. • •• •••• Sup'ts No.... person injured, r:ameof OtCIIPation, ,+-Aooident, 0 011/C OJ Mine No. .... r."RsoNAL INJURY. oFPv ~ L.J-- ,_ ,., /I ..c..J Room No. ~ /;l.t.-6- Mine Supt. eAC/' Name of Mine Forman, 4-{7, 11ame 01 . • .d ...--'=3 o M . ' ' -vt...P-p ,f person ///JUI e ' , arned or Single • AgeOJ ~ -<--12.__,J) r.amilY, if any, ~ <-J ht wan • C d:c~ Cd.. • 11 ng in employ, of o., / ~ ? ,tron °! Life or Circumstances '--------7 010 10 H d ddress of nearest living R tiue, /~CA../ .,7r~ o. g _ _ .' Name an a 2-t:,,_,,,./ ------o---~ v '--H1/'D' ' ;:>f. Was he all efficient man, ~ . . , .fl Was he temperate, ' d ; whose charge left, ~ ,,,_ _____,__.. ';f~ , , . _J) ..:::7~ ~ ?'~~Q~ 11 Where a11 . ~ 0 n;:::> . --'1._ 1 A ~ --: ,f Physician called, if any, v l .J-V--., 0 rf.__,.. <' ../ flame DJ • '""---.J , o• 'I Adress of Witnesses. Name and P• O• I 1\ I .., Nature and extent of Accident, ;; I j -\j I I I'I 1 I l/ \I (Signature) 7 Title, I �STATEMENTS OF WITNESSES. I I Rock sp rincs "1yoo~ept 26th, 19o4 II I , I I \j I, Thomas ; cQ.uillan -aae <11th '"ill.i m,. 1r~dale on t h e 9th d~, or Au,·ust 1s o4 •ahen he hc.d h is rich t foo t cris~1 0d h y a p i ... c e of ~ ' {SG'.J ) Tho!nus 'j cQ,uilla n Reel--: Ss,ri ni ..s Vlyomini • Sevt 26th,1~04 Rock Sl,' rinc: , ,~y c,minr: . V'u th o ·.1i 'l.. n 8ss es t o n o c i •,.__nt of unloading t• VTi l J. io.m I rc: da le v,as e tune.~ fo 1~ .., b oR c c.r l o.:.d~ r out. of a vmgon -,,r..en it upset ~d fell c.,n his tcot. ( 8 c;d) 'l'hol'.!lo.s J'tc Q,u illun Bruno S tebne r CO?Y �Form 12:J. oNroN PACIFIC COAL co. fTl 6 --- - - - Mine No. ........................... .. r OF PERSONAL INJURY. ~(lf'OR ;;;f ~-~ '17 ,9 . I D. - ,. - ~ . - ...7~ f> ':t', 0cc11pation, of Accident, oatc ~ Location, . . iiured i11 Mme, state ' 11110t //& ~ offdine Supt. ~ 8up'ts No..................................... ~ ,; person i11jured, 1111meo1 //cone . . Age of Person ul}ured, 1.4 E' 790 , / Y- Mine No. /?. _ , ~ c:7""'~ T,·me <f' ,:?"'' cJ . ,, E ntry No. ~ . , , /~ # ~ ~ ~ ( . . / N a m e of flflti#'ffi Forman, ;;). g /- 0 Room No. • t'J ,,_, _ ---- ~~ / P _ L? 1 ~ -·: v - ~ ~ ' " 7 ~~ I I 00ndition of Life or Oircumstances, ~ . Was he temperate, ~ Where and ;11 whose charge left, /lame of Physioian called, if any, ..___ P Married or Single - Whal family, if any, tong in employ, of Oo.' 7 ~ I HoW t • • 1 d address of neares 1U111g Re at·rue, an I Name was he an efficient man, n. c..,. , ~ n,,_ y _-:?'~~ C?-e-e_...:q1 11 I I I I I I /lature and extent of Accident, ( ~ I 7-U.. ~ (Signature) 7 Title, �STATEMENTS OF WITNESSES. �Form 12:1. ~ p;\_CIFIC COAL CO. r1r6 vsror -------of pERSONAL INJURY. J<!tPOl?T Sup'ts No. -&-~ .I perSoll illjUr<d , -~(_,, , ~ , _ , , ~A..,; ..:5- 7z, - - , 790 ,f- Time Mine No. I //111110 OJ o•ciipation, ~ ..f Accident, 0ate OJ t , . . . din Mit11', sta e w11e1 e, ~ Locatioll, If not 111)111 e p,1"'ofA1illeSupt. Age 01..f Person .i11}ured, 4-ui, What family, if any, Holli Jong in employ, of Oo., name and •••••••····· Entry No s~(NameofMineForma.n, --3 ~ . 4 -r- o .-o <7;7J( Wi s I t emperate ~ e ' ¥_/ UJ-v , ~ •~ • -, ,.. ~ - /lame and p, o. Adress of Witnesses. ~ 17~· c...~ , (Signature) 7 Title, Room No. / Cl? o ,e~ Condition of Life or a· ircumstanoes, address of nearest living lle/atiue, was he an efficient man' f ,.ft Where and ;11 whose charge eJ , a,,of Physician called, if any, 1 • •~, ~ - , • 'Z1 /L. Marned or Single of. .______ f/ature and ex~ent of,Accident, C7 / ' ~ ~r.,;:? 7'-t.:: l' �STATEMENTS OF "vVITNESSES. '" ) J. �,T .-rr,Jf01'> ,rrJE u PACIFIC ' For111 12:l. COAL CO. - - - -·· ◄ pJSRSONAL INJURY. j?f.poRT oF ,f 11ame OJ ~ person injured, occupation,. ,1 Accident, oatc OJ ~ d;1. C/ 71(:,,,-z:::,_ _ ,;r c f ~ . u l.-4--Cef( L0cation, . . , d in Rfinc, state wI1ere, I/ not inJUI e 790 ✓ Time ~ C?.¼, Mine No. 1 Entry No. ~0 Room No. ------------- ~ 4, - ! f ~ ofMineSupt. -~ - ~NameofMineForma_n, . i ~ -<-Age of Person !n1ureG' ~ Marned or Single ~~ What family, ff any, c2 tong in employ, of Co.' - ~Co 17dition of Life or Circumstances Hotv d address of nearest 1·. RI t· "7__ -, ~c1/ ~ w111g a a we, , . , .•.-~ name an was he an efficient man, /-:l. • Was he temperate, / nd in whose charge left, ' ~~ _ -:2/__ _ _ Where a . ~ /:;> .... / ·r-r~ ,f Physician aalled, if any, , v ~v"Y'-, ~ O name c,., {lame 'J I)' I I II 1: \1 Name and p, o, Adress of Witnesses. .l ll I II : Nature and extent of Aaaident, ~ l 1~l I I I !! I ' ; (Signature) 7 �STATEMENTS OF WITNESSES. I ( Roc k s p ri ngs Wy oming s ep t 23rd, 1904 v.'hile I wo.s v10rki i:e; in my r oom :1/36, 4 e n t ry No 9 mine, t h t; r ock fell down t o my buck and in.j u r e d 1 2th duy of ~ ept . Y r•Uf' f:l t ru ly, x T Takah ash i Ch eck 1 50 :/:9 mine J uy un en 13 A ·~m t �, T tJIE UNIOn_ J?fWOR P.ACTFIC COAL co. Mine No. T OF PERSONAL INJURY. •••••••••••••••••••••··················· 8up'ts No..................................... 11ame 01.~ Porso11 injured, occupation, oata of Aaoident, . ~4(' Locat1011, . •iired in Afi111', state where, If ,10t mJ Name of Mine Supt. Age of Person 1111ured, What Family, if any, L· r Time Mine No. 9' /o Entry No. Room No. L, J' Marrrii?:~; ;7~ ~ ~ G - - 7 i h m e of Mine Forman, £ -.,_ 0 d _ 11 ~ How long in employ, of Oo.' ~::& ~ ~ Oondition of life or Oiroumstanoes ~'o, k Name and address of nearest liuing Relatiue, ~ was he a11 effioient man, ~ he temperate A ___ , _ _ , _· / - ~ - .» C/.,9/?::;.::::?_• ~ ' . / ~ Where and i11 whose ellarg~ left, {lame of Pllyeieia11 oalled, if any, /F, ::Y>-4 /° cJ ~ , __ Name and P. O. Adress of Witnesses. : 'I l Nature and extent of Aooident, (Signature) Date 1 Title, �M"ENTS OF ,vITNESSES. STATE~·.1. • p,1:, Ro. 9 !li ne, Sept. 21st . , 1 9 04. f; • (;9 ::ti I n ju.reel :.ian ' c St a. t eme:nt : I was r unn:i.ng c.~. lJri J l jj:ig na.chin e on the new p l a ne i n 8 room on t h e ZJ e t; do.y ol ~:opt crnhcr , a b out 9 o' c l ock A. ;.1. and the dri l l dropped out of th e s ocl::et :f.'rorn the t r, r ead ba r and the p;a.chi ne over - lie.l anc ed and I tried t o b ola the m&chine r.1hen it caw;h t my fi r ~t and s econd f ing ers on my riGht hand i n t h e f r ume of the n;nchine. a nd brui fie d tlwm . ( 2i r·nca ) ..., X r:ike Stor ev There was n o one to b J ame J r or the a c e i.dent b os. Sou l s y , I.li ne For eman . . ., �ibe 1rJE Form 12.1. UNION PACIFIC COAL CO. _ 1 e~ __ _ Mine No......................................... , , OF PERSONAL I NJURY. Rp;pOl\ 1 8up'ts No.................................... ~~ ~ Name 01,-F Person injured, A , • / -<Y ~ t occupa ,011, . -<t:1,fAccident, h ~ I 190 ¥- r Time 9' c? ,.7-z,,.' O t J oae /ff? -011 f f < ~· Mine No. ~ Entry No?/.P-tv ~""4Room No. Locat1 , . ,iiired in Mine, state where, --------------If not 111., ~II I Name of Mine Supt. -~ ✓-~ Name of Mine Forman, Age of Person injured, .,.L _--3 ~ What Family, if any, ::r How long in employ, of Oo.' /,-fl ~ Name and address of nearest living <f:relatiue, was he an efficient man, ~ Where and in whose charge left, $t, Name of Physician called, if any, OP I ' Oondition of Life or Circumstances ..______ ~ ( ' ~ _;;>;f Was he temperate/' l ~ ~ ~ (1 ~7 a ? ~/ Name and p, 0. Adress of Witnesses. Nature and extent of Accident, ~- l 'I ' ~ Cbint. \ , 1 I I I, I \ (Signature) Date 1 Title, j I I I �STATEMENTS OF WITNESSES. lI 'I I ..i I ,. I �-.T !Y·': Fo1m 123. PACIFIC COAL co. rrrE uNro1.,._____ _ Bl-WORT Mine No. OF PERSONAL IN] URY. I .. . . . . 8up't8 No. __.. ________.._____.. ____ .. _______ _ .. d ::?f~ ~.; person 1111ure , "' , ~ 1✓ameo1_ • AJ:!;!;'=-c-~ "T" Occllp«ttOII, oate of Accident, J ~ <f fie \ 190 ~ Mine No. Location, . . · ,red in Mme, state where, If ,10t tnjl Time -----3 Entry No. / Room No. 4 ' { Name of Mine ~u~t. ' • /43. au.::>-,r-~ Name of Mine Forman, , r --e /Q--<-,~ Age of Person m1ured, -3 ---3 Married or <i,;(g1e _..,d'~ What family, if any, ~ 0 How long in employ, 1 Oo., ~~~ /,;c~ : : : ~ fl..'(_f~;on of Life or Circumstances, ~ ~ •/:8 ~ , ~ _'-.. , ' ;;:l~ -~~ .-.,-I'. ,::=-,~ame and address of nearest living Relative, ~ - ~.~ N , Was he a11 efficient man, ~ Where and in whose charge left, Name of Physician called, if any, ~ . Was he temperate, lfa--<J O £ 4-, ~ --,..-- ~ ~ Name and p, O. Adress ~nesses. ~/"iL1-o-~ A::'..17 """-~ Jc: '1 ~ , --V'"~ j ' a ~ , 1 I 1 I (Signature) I �STATEMENTS OF \VITNESSES. �( Fol'ln 123. N PACIFIC COAL CO. ·aE u.NfOl 'l ----->T OF PERSONAL INJURY. 1. . N M1ne o. .................................... R81-'0[\ 8up'ts No ................ ................. .. ,F person injured, , )11 • {J(lllle OJ. C. l / . ~-Q n/4--~ occupation~· @ - e ±- :.....,.oate of Ac 'den , . • ~ ..h~ f Locat/011, t 'nl]·ured in Minr•, stat where, f/110 I ~ 0 I D L.J. 790 I Mine No. / Time o J~: 3 b tfJ 'Yk____, Entry No. / }ttrY ~oom No. ~~ Nam• of Mine Supt. _ Name of Mine Forma,y ~U,v.;, v,_,<__ Age of Person injured, _ .i/ 6 . Marr;fed , r Single m , ~ o e . , What family, if any, 6 ~~ How tong in employ, of Co.' c2 {) ;!::f--e_ ~ Conditi°j '/. Life ~ircumstances, Name and address of nearest living Re¼ltiue, V°(_,.,,,~ ~ l - / 4 ft=> was he an efficient man, ~ _ Was fie temper*te, Where and in whose charge0Jt, )~~}I.. tft-e._~ ) •~ Name of Physician called, if any, U ../--c'-~~6<-c.......c_ ~ U< ) Name and P. O. Adress of Witnesses. Noture and extent of Aooident, (} ¥ ~1-- ~ ~y;:l,;t-,t...oZ.-<f a~ e_cj rr, ~ ~ o<- 1 ,1·, II' I 1. I 'I I (Signature) Date 7 C..1.,r,.03__011 Title, �" WITNESSES. STATEMEN'fS OF �Form 1:i.1. ~ p ACIFI C COAL CO. ~ vNro.. ffJr> . Mtne No - - - -F pJSRSONAL INJURY. •roNT o RI~ J:;eg o•cuJJatioll, 0~ d- 1 Location, . Mine state wh ra, I/ not ;,ifuret1,n , , Minc Supt. 1111me o1 • d Age of person ~111ura ' •••••••••• ··- ••. ················· ~-t-o-~ , ~~ c ., Accident, /.J _ ~ / . o(ltc 0, ~v 3 1, .,.9..-1...~ 790 f :::::f. Mine No. Time c:2... (7 "'?--e-r , 1 Entry No. ---- - - 8"' I Room No. .__, 1 <L. r ~I~ Name of Mine Forma.n, M =-'- f. .. - arned or Single ~ ~- C?~ What familY, if any, ~~ . . ~ / 17 rlit,on of Life or Circumstances in employ, of Co. ' / Oo g HotU Ion ddress of 11aarest l1u111g • • ReIa t·we, ~ •,-/ rP__,, . ,;:1 ' ~ - ~ · #ame and a ~ \..... ~ VCd'-tJ.1'• was he an efficient man, cf' n _ , . Was he tempefate, ¾a d in whose charge left, ~ ~~r-..,.4t:::, C!!4--t-d.-,.,1-_ _ v7 11 1 , Where a . .-1pJ1ysiciancalled, if any, 11ameo1 ~ ~ vt, ,/ ✓¥-~c:..:::,~ ...__ • ,........., a?"~ • .J'/ 0 1 I ,d p a Adress of Witnesses. /lame a, - ' ··•····················-······-········· 8up'ts No. • 1·u,·ad' erson 111 P //time of , 1 • • ·I 1 (Signature) Title, , �STATEMEN'fS OF WITNESSES • • !~c,J ~I-<~ o,Y s ~ 1 o... ;,1 £v- ~ • J ~ ~ d , M~ ~ 1 'i ~~ d ~I ~ ~ ;L ~~- ~l --,- -k V~ ~ 'yt,:,,, ~ -4,' ~ ~. ;t;L -£,_~ · , (J~ dz,_, -8 Y/,v ( s;r ) a_ </r7G2y ~ ,) .i• ··:· .••• ( .:- 't't �"tJ Form 12.1. TroN PACIFIC coAL co. trli ON -·-F PERSONAL INJURY. pµ,.·110NT 0 Mine No. ........... P"'°" ;,,jured, (!..,,,-~ )~ occ11patio11, . ~ :2 lo 1 Accident, -• Ollie ~ '7/--~ · -1/ '-•·I ... - ~ at1011, l 00 . . . d in f.?in e, state w1,ere, Ii not Ill} uI e 8up'ts No .................................... a ~ d1y. 790 Mine No. I - ,,., 'b . .J ···············~) . ' ,· 11amao1 1 ,-.; ;1 1/ Time /tJ' I Entry No. ~ 1\ ,> .__ , , I rf Room No. 6' I. ! ~~ Mine Supt. /3 Name of Mine Formana~ ~-o1 . -~1 I 1 Person in)IJ!'ed, Marrie - Single Age o1 . What family, if any, {TI.-<-L,....-c...~ ~ long in employ, of Oo., Condition of life or Circumstances, Ho!U d address of nearest liui Relative, • 7h<.....-t...--~ SA~ _, • Namean ~ Was he an efficient man, a ...-. Was he temperate, Where and in whose charg eft, CL... / ~-~,.,,..,_,,___ ~ l . . .«_ .1 Physician called, if any, .J-o.....-<> Name 0~ • zl .. J;;::4 I 9r2~&>(,, -- 0 /lame and p, o. Adress of Witnesses. I . Nature and extent of Accident, I lf \ (Signature.) 7 Title, �STATEMENTS OF WITNESSES. J I ettlt 9tfj tt!B ([. I b9rlo1 l1l I ,bobso! '3a j orr as 9rro no q, t bira , iltJ~ (qsje I , 8 !lo:, 9tU :i !~~ r ,Isa �STATEMENTS OF WITNESSES. /"11 I ·• -< v I Cu~herla.nd, Wyo . '.!.C\-6-1~04 • l d 0 JV, ,,e hcn1e rrow No~ 2 a.bout 6 o' clcclt on the evenlng of 'e~t cc.,(,uber. 5t'i'l. 1004, •anu t.bc rt ralJ~ed from the Li very Stable to J na Cha.o. !~vine were w1 th me on I tno l oP.! ':ii~"' hcuce . Hick liendrcn r--1">- ,· I : ..,;·✓ i t.hc ctri vn and they had been drin1!1ng very f'reell' • I had tak en a few !l!"inlt s ,.,1 t.11 t he boyn, but not enough to make me drunk. l went to worlt at 7 o'el(,~k and went down into the 1111ne , where I was r unnin~ an electric hoist engine on o down hill ai r course. The miners had a.bout three el"lpties and they had sw1 tchcd two when ! went i n, tiut I don't ltnov: how mc.ny: cat'"s they bed loaded . I thlt l t was e1 the r the fi r s t or second car, nnc1 the cng1 nc eoes not set ~trat ~ht wi t t the track , which allows the ropo to pi le up on one ~idr o~ tlie dr ur. o.ncl when 1 t falls off 1 t letr, the car jar back, and ! n! , .... 1 \ • nfra1 d i t would e1 ther b'realt the .i·ope er n-0,rc tho ongi ne. I stepped· drun, 'llhile 1t \"Jan 1n mctior: . t.o thrO\"l off. the coils a-round to i.,he r!r,ht 1 got cn.ught -1ry "hand in the dz-u.'T· e.nd to save myself piJea u p , and . I the 1cr .._ hand i n .:.1 so. I knew t he engine .ras not square v•1 th the track and I had never reporte.~~ i _t , which I shou l d r.a"f' done and should have refused to operat.c it unti l !"ix ed.; t he day man . ·:.. �,,, -· ., I r ./ I .. f J t I' ,, l l✓ l I /.; .., l I'\,,''\,.-. _,, 0 /.,J / n Q I { ,: -- + .' ,, I / J Q) l/\ \ \,._. .' ,.. t. :/ f . -✓ ' I ~.J - ' . I. • _,//2, . (. : ' ... _,, ,., _ .,,., .. J �~-~ ~ ~ • ~ ~ '~ - _.- - ~~~~~:.;\. -~ .., -=- " - ~-t-;;,_ .~ -=--~ " -~ - ';;. ··:s~- ·~::-~~-~ '\"". ~ ..... ~."-~ ---~-- t.\ )-~ ' . ""';.';. -~-. ~ ~ \__ __:_--· :. \~~ -:7,.. -i: - ~= ~ ,;. \· ~~ j -i~~ -~ ~ t ~ ,~. - - ~ ~ -=<C. ·= . ... - c-.f .,, ...J.Jl ~ ,,--.'.'.:". -; 2 - --------- "I-. ::I' • ) " •• <SY I ~ - < - - - -- -~ JI ii +s's: .- _.'r' .t,. : ~-1 \ . '~::_ '''i \1 , r , •• :·\-D R UM (/J ~ t'i:l (/J (/J ~ z E-4 J':!.t 0 (/J E-4 zt'i:l ~ ... r, ' ,, " ·'-.. ,_ • , I r 11 I • ! \\) ,, "' ' ·4. ~ , .''\ , , he.re 51m k 1r ,s was ca u Vnhi· - -1 l•. , , ~ 'rnrf) ~ ii .w I a , R r.=p~ h--::rv,,: i~ 120 0 ,{L . -- I ' : 1·t ::~• l,n. :, ",t>, Wc5 o e t 4 ,,o f f::c:.1r:r-+:: .._, ·:::-i:,ut!i. . l _i__ .U I . •} /~ \-\. \ \ \ '\ \ \ \ \'\. \ -,' l of \,\.,\ \\" \\.~BASl<. E N TRY • ~;:,II-:: ;- Di-=,Jc:r;c::c Fr o n, "-·or.~ +o Tr-1, R.3 ,I = 2 , -:::. f1·. ,:2'fe• ! 'I "\ ··--- , ' \ f \ ~ OR.UM l.- . i ,, 'I ...-- en ,,. *·~. II! ti'J ----~ J ; ~------ -- ~ • I I \ • \"",_...., ~ E-4 I \, ' \) ., ..• '.\\\ y ~ . ~ •• . • , ~ I . , , Ii' , ~l I •.f, t ' •·I \~-~ \ • I I i .; •--~ . ( l r' l I ; i I - - -- c.. • -~ .fLJ.!r;:-;-,f ~..t ", , rm---- r.... 'G'' " ,-. .,.. ,, \I~ -~ ::J - "' \ ,-._ Rollo,- ,; f " ..,_ ~ t I; ~ f r~;;f~-tch .~',rlOH·Y/ lfl. lor.atlo11 ,fl//llli/1r~dl-eide11/, Sc ,1c .· 1 · '"' 10' .Y. I.)' • ;I_ - ~·- - - 1'" -v Jj"' ~ ¥:1-~ . ~~~·¼// .;r~ '-t>'.I ..r -- ~;:; f.:i'. ~ ~ L"k f+. p ~r min. • ,;§:::7_; C :,._ - .,,#'. • ,. ,;I • �li'orm 12.1. ~ , ,,.,n ;,,jur'.d, ~me of P ~ _ , 11 --je~ t~~ -I ~7.- yr, orct1/1atioll,. t ~ t , ~ S ck, (I 190 /J Acc1den , / 1 oatc0•1_ ·/T) _ . , _ p ~ f 1 ~ Mine No. ~_ - ~ - -- ----..,., J Loc!lt101'1 . Mi111' state where, . I/ not ;,ifured /II ' <rz_,__,_ /4' ~ 6- Minc Supt,Q , ~ /Jame O1 • -_/ . eof perso yfJiJur ' £ f;,, T <£-e..<.-v.l ~ -t / tJ : , nne I /J Entry No. ~ Name of Mine Forman, Ag ~1 IIY Whot fan ly, I;, ' l-v HotV tong ,n employ, of Oo., -2_ . ~ J ddress of nearest ltumg Relatwe, "),,t,/l,(.A Name and a ~ ,mcient man, . , wos he an e;p I Where and in whose charg . le t, ,., •f Physician called, any, 1 .,.. Q,.., • ,,,~ Room No. J ) ,/ ,- I) _ t1/fl' 't::l!~ Married or Single .,-::-. _ ~ """-"-L-,t. eu ) 4-:r~,__.,_ ;;r- ~ (,)LL-~(/ ) )4/ • J -r - LI Ll2-,,( 4L-<7 LL-.,- ) 1A1 1 ,- vvas 1e temperate~ LA --<- <-.: " P~ , e.. . . Oond1t1?n of Life or Circumstances, <-L (5U , tJ . "' • /) (£ 0 .j} ~j7~ah (//udi.,,tJ ,,/p--e... Adress o1 Witnesses. Name and P• O• j/r(rc -' d •I j f ) ( �STATEMEN'l'S OF \VITNESSES. d'c. f I I ,,, �1,'orin 123. C COAL CO. ~ pACIFI • tn~ro. _ trrG - 5RSONAL INJURY. r.'J'oNT oF p \ Mine No..................... .... ......... ~•,, 8up'ts No.................................... . c/·~l p ,son in111red, :·Jme of o i / / '- ~c~rtf}llfion, • I t .1 Acc1da11 , - :Jt~ (/J ., (' .._..,..,..,)-;>- ~C<--G-<...., ~ u;..,\..--' Je,,/1 v f- < v v v t - ~ ~- ....v V ~ " t , . . p.J, I l 'z. ~ Lee,atioll, /"'I d •' lfim• state Lul1et'e, • ·ure 111 • ' If liottilj • . Supt• f::.~ .,_fr> {:?? 1/,'am.,ofp Mino ,son injured, 7 190 Mine No. 0 L/ Time ,f : J CJ ' a_..,_~--/ £11 try No. , ~ f< Room No. J ~~ L--- Name of flline Forman v.J , -I / v,,,_(.-'!_ d-z-<--, -<. Married O'r Single 7~c....--.._. • i 6 • Jgc 01 . Q2..-.....-<.. f . ~ -..., t family, if any, -.JJ . ~ ;'/ha in employ, of Go., ~ ~~l-uA._ Oond,t/011 of Life or Oireumstances, Horu fang ddross of nearest f,u111g • • ReIat we, • rlJ. --v? /:; ,,,.-,-,r-~ 9~ h / d 11 .:'7:r-L d Kame an a h an effioient man, ~ r,•as e d in whoso charr/i)teft, oL.rr Where an . • < . Was he temperate, c--/./- ~c.--..,_, e.-_, '- d b-o tame o,., Physician called, if any, - '-- r . . j I•••"d P••o Adross of Witnesses. { (Signature) 7 Title, �STATEMENTS OF WITNESSES. �NfON PACIFIC COAL CO. ,-11E U1 __ - - f?li'f'OR1 , OF PERSONAL INJURY. Sup'ts No..................................... ,r-- ,.f /1£1//18 o, person i11jL1red,, . cctl/J<lt/Oll, O <!!/'~ A J J ~ Y}'?.,v\...-r~ •. , ?, , I}-,,- 'd,,,,. :I U?--e...,,,~-oatc of Aca;i en_x, / 4 1P: ·on C 1,,tre. /?. ~ '1.A-c ? tl Locn Ju, ~;( __,,,,:J_,lc,._ e....., /I ~ Time 100 , . .., Mine No, , /4ine Supt. Name 01 . . J Age of Person ~lljlll'Bd, ~ Wh£1t Family, if any, Hocu long in employ, of Co., 1 -c;l.., I ~ i (... a~ Room No. i /lame of Mine Forman, (r"" ,,/ __,,_,_,__e__-c,~f',_cf .6f. Marf1ed /' Single J,n Cl....\...A,.,,1.,..<!. c-(__ ~ .~ · ~ I "' ' 3 tJ ~ , Entry No. L Condition of Life ?r Circumstances, Name and address of nea@,fir (l flumg Relatwe, ~'-''--<. ~ was he an ejfioie11t man, v o .1 / W0s he temperate, Where and in whose ohar e eft, (2/j...._ il---v--c.......<-.Q_ . Nat»e af Physician ea/led, if any, '7,l~ ~ ~ _u { 7 r a~ /lame and P. o. Adress of Witnesses. Nature and extent of Aooident, ~ ~~ o( 4d_ t3u.// Cause, I I l (Signature) Date 1 Title, �I ..... . •. ~ ·~-' ... V\, I I r r, . .-...- ' ! ,,. 7, •. I , ; .. ~ ~- t /1 , :1/' , ( ·"'\ - :J / I 1 ... ,., ,.·--•"-.~ ,· _.,, -- ... I . ... . . , ..... (. { '"· ~,· •l t I ._/ ,.. .. / .. 1 . ., r I I I '" ; •' - I I ' -¾,. ,., .... I ~ l ·~ \ II Ni Lu- tc vt, '1-1 O..{ ¾. ~ t ~ Q. J/, �1 flj · 7'- ~ 1'f0N° PACIFIC COAL CO. Mine No. ............................ 'l'llr; Ur .. __ . . F PERSONAL IN]URr. 1 8up ts No..................................... 0 J,,1.•f'ON1 • . • ed ,I person 111) 111' f,'il/11C0J. ' llot.~ ~ ~ occupllilOl:~11t, . ~ ~~~A~ a-a...J!. 0 - ~ 790'-I Mine No. --~ - I ~ . . . d ill min<', st te w ,ere, U L·c,titOII, v I r Time . ,j I ~ ~ Entry No. -,r .9 Room No. I C> ~ If 11ot 111]111 e ~ ~~ of f,iine Supt. 6 (lam .1 Person injured, 3 t:> Age o, . .____, What Family, if any, long in employ, of (Jo., ;? ~ How • ReI at·we, ---. address of nearest 1·wmg d Name an (1as he an efficient man, ~ --d_ Was l~c temperate, ~ ~ Where and in whose charge_ left, Name of p11ysicia11 called, if any, ;, Oondition of life or Oiraumstances, / ~~ f<.. U)./- CJ ~ ~ ~ /lame and p, o. Adress of Witnesses. Nature and extent of Accident, tef~ ~ f 7 !)_ ~ (Signature) 1 c.,.,....11-.cu. Title, y- ~ 7 I ' �STATEMENTS OF \VITNESSES. s ri .. h 190 · y conoern ~ i,: r •1~ uhi!.e ongazed as utt ra .,__, tha t IT d ~fsicyde 1 1 co?"tii'ioo . ,... t o'.P th~ min·o • ·,yo \then com:1.n~ ou Va11ey,' • S-ni•~n,7 0 i · e o . 1 o. t ~- - ~ • . .~ a nulc up t1.il.nTT..1y , , .. PI" l'o· .2nll 1904 I ::l,'J d~!v ...ng To ~ om t r: nboi.lt f ive oo ... oo when .1 hit it on .. l:• ohor."~ s t lcl~ ,hav!.r!g tbc l '.nu quarters tt1t .. '-'· 1 h old of t he rnu.1 ° •1 l.. • " "' t t · o time . '--0 -~ I hit tho mul~ 1t kickc,1 ' teet 1.an n i n t he feoe , cut-t.·· 1 ntr no e "'rtl knoc:i:ing ou t t·10 m e resul t of uhich I uo uncon..'-"' o loua fOl' 10 minutes 1 hv Copy I 'lflE TJNIOU I;ACIPIC COAL CO TO l'lHOi.i'. IT HAY COUCERH Thiil cert i f 1cs that : John S.H· .y~ .am engaged a:-: ~ D:river i n mi ne Ho.l at C:._,,,1ng Val ley ":/yo. I Pa~ ·«or1cin~ tn.=u: en ilo.5 Ent ry aJon~ \Ti t h Ted Att 1.~;,a.e.cud1 ~~iv,.nz a si::"r;:;_,: :~,;.11e. Abou.t 5.05 p:n 11e were otarted out of tho mire and hau c>'!"os::e:1 tha s:' opo and tho Ol"oos out , aml was jw~t ~tir--:i.ng 1.1.p th9 ma.n~.ly , hen Tea h :lt his mule wi t h a o1:io11t 1,iece or t-1tick on t·,:;; h:.:::! q:iarters.he at that time h.' \d a hold or thi:? mt:'.'leo te ~!. li'hen he hit the mule i t kiokea him in the ruec-,k~t'JcL:.,.~ ·1·;,:1 sensel ess . He was unoonsci ous fol" oome t ime -.hie n o::C;> . ' .,.. ot his t eeth b~oken out \.' ... ("I �raE Form l:?:l. UNfON PACIFIC COAL CO. l REPORT -- .. 152 l - Mine No..............................~ · 1 OF PERSONAL INJURY. 8up'ts No.................................... /lame OJ,1 person injured, . :;;. v<_ Cl~:k -vv-<--ocoupnt1011, ~vv-· ~ • JI() L oatc of Accident, . }/l-:. ;l._ ~i ~ Name of t,fine Supt. or I I.,. How long in employ, of Oo., ~-~~ Relatwe, Name and address of nearest llut Was he a11 efficient man, ~ _ Where and in whose chari} left, ) ~ Name and P. O. Adress of Witnesses. Nature and extent of Acoident/ Room N o - . / ~ Name of Mine Forman, Married or Single ,✓.~r ~a 0ondition of Life or Circumstances, r ~ ~ L l~• tL;; ~ --& ,L Nam• of Physician called, if a11g, Entry No. , '$. ~ /] Age o,,I Person .injured, What Family, if any, I Mine No. Loo11tio11, 1:v-, . .,,r. din M" 1 , state wher~ ifnOt I~ 1/ Time 190 u _ Was 1e temperate, Ci:.~ oL~ , ., ;,_(J<- ~ (J ~ 2-{ /7 ~ ~ /~ct .,,_, ,,__,____,,._L,_ c,(.,, ){ JLV J o <l.L J_ ( j I I (Signature) 1 Title, �STATEMEN'f8 OF 'WITNESSES . IZrJ f!,.__,_7, ~? J-trr- / - •, J,,;,,-t::,(., -:L~ f {-"-"-- LW ),I ~ f w"'-'{__ 1lt,,j d / 71 ,,.___,4 d' ~ - .....-~--£,-,,,,.~ L .. I •. ' • .. �. .. .:• 6(':y I vioit t:d th~ I . .. . ,la.c \3 th.... t Jf Na k u.za.Y'.. a i:1c.s injur,. d a nd I f c)v.nd t h•L. t h had fir e d on e s h ot an d th.: co u l J'd l 0d to come dO'lil no He then fi •• ·d ~ aeh.t from the o.v11oo i te direct ion vnd it o,lso f uile d to t-:cc omp lis h i ts .iJUr,,ose ·wi thcu t sprc.ge ing t h e c oal, h e t hen l u id d o 1:m in fromt of ota rt0 d t o r:dne with th6 r esu l t t ri...t t he C OL'.l j t v.nd fell on h im, injuring -~.,,• ··. ... 1.:-- • hisl ees • ( S: ·d ) ' }co o 'Pi Pry d e ., .' .v ' ,,::,,.-J.; -...'i �1g r.< rJJ.o Foi-m 123. UNfON p A.CIFI C COAL CO . ]?JSPOR •·'f l M'1ne No. ......................................✓ l) -- - - T OF PERSONAL I NJURY. J:/- J1. e..-~ flame O;,+ Person Clinjured, , . / ~ oceupat1on, r:tz;· oate of Accjdept, 11,,,,,uy-Location, (J{ tre,,,,/1. df,r,.A.AAIf not injured in Miw, stjfte where,u r 8up'ts No. .................................... o r:1/ f=' ~ Mine No. Time S,- 3 tl-;n--t ✓ Entry No. / £ Room No. a'4i~ Name of Mine Supt. ;t:_4/!_a...c..-/4 N~me of Mine Forman, /if Age of Person injured, $' Married or Single ,, .;;__;_ . ~ What Family, if any, , _ _ _ _ - - - - , ~ ( 7 How long in employ, of Oo.' ,,t./ Oondition of Life or Oiroumstances, Name and address of nearest liuing Relatiue, 7 ,,,__,~ ~ P-t..-.sa-t - -i",C_.,(_--·~-=L----,,a- 7 Was he an ~jficient man, ~C--:7 , Wa~1e temperate, Where and ,n whose charg eft, "7/.b;:f.-L!" ! f _ ~ , / - ~ e<.__Q_, Name of Physician called, if any, ~ e . c(_ U O,,,z Name and p, O. Adress of Witnesses. Nature and extent of Accident, cl )( ~ -e_ d C<.._ /d ~ c,<_, ~~J ~ (Signature) Date 1 C-1-1:;.03 ··OU, (~3 Title, ~ V I �1.64J. 'j,1/ f~ Form 123. N PACIFIC COAL CO. f!lE vNIO - -- . - · - · , PERSONAL INJURY. • Mine No. .................................. •JJ0[?1' oF J?b 8up'ts No..................................... ~ ~ U. ,; person injured, 11ameo, ~ 111 cupation, • /I ,, _ Oc if Aacci· nt, 7~~ ~ oata ~ tye--/~ ~VV',.A/4--<-r , Locat1011, . . d in Mine, stat w1Jel e, • If not /11jtlYC Nameo/Mine811pt.:;:.,, ..t.l 190 Mine No. r Time 7 Entry No. Room No. ✓ ') /3 / c.,tJ / :{4.ll_o-c/4 Nam, of Mine Fo,man,l f ? L I '1 / ~~L Married or 8,ng/e ,,.-.:i....,.__.__ I .1 What family, if any, _ 11 I ,..-/ .. . V HoUJ Jong in employ, of Oo., ~~ 0 . ~~t/!h ,iond,tton of ~ife or Circumstances, ~ address of nearest living Re/atwe, . <- 0 / o.--R. ~ ~ fl , ~ Name and t1 IA/ o ,,. Was he an efficient man, i i : : < 1 _ fJ _ , Was he temper~te, Where and in whose char e eft, Sc_~~ -t..,. E- ~ a-.-/Z a_,,,,/'-·. ~ Name of Physician called, 'l any, ~ IJ- ~ d... ,1 Age o1 Person in1ured, ? .._ . ~ z = ~f Name and P. o. Adress of Witnessesr , ,6) a-12-e_ ~ "----, Nature a11d extent of Aocident, ~ v-J 3/'J ~ (Signature) Title, �Form 123. UNION PACIFIC COAL CO. rI-IE • .i: R&PONT - -- - - (,& ,_.,,, - 1 ( );} . Mine N Q.......................... ........... ~ OF PERSONAL I NJURY. 8up'ts No. r ,; person injured, Yl • 71 ~ Name o,. ~ • ocaupat/0/1, oatc of Accident, ')1,,u-r- I). • Location, /lrv/4 - ~J7 If not itifured in n?inr-, ifate wh8n, Name of Mine Supt. 190 Holli long in employ, of Oo.' ~ J - . . _ - 1 1 v J ~ Name and address of nearest lrumg Relatwe, ~ _ Where and in whose charr/lleft, 7/-r4 Name of Physician called, if any, /Z Nome and p, o. Adress of Witnesses. 0......:....... Entry No. k::. _Vi Room No. 3/ ):: .di. . 77J fl J Marric;fi gt Single ,,-yy,_ ~~ V ~ o0 ndition of Life or Circumstances, - - - - ~tA.. t.£ ~ Was he temperate, ~ U 7/-- a ,-,,-,,,_'c(-· /i:._ c. c;,(__ jl'cJ- ~ (Signature) 7 ~ _J D-o-7A--<I Was he an efficient man, 1."!f.-e-<, • f : o () Name of Mine Forman, .--L 4 J;i;:v-v Time Mine No. / !tu, ~~ Age of Person ~n1ured, What family, if any, f Title, .,,,~ 1/ I �tHB UN roN PACIFIC COAL co. l - - 1 M' - , -e l.t i () u ,: \ 1n e No. ........ __ ..... _...____ .__........... _- ~I F pBRSONAL .TNJURY. J?Ji.f'ORT 0 8up'ts No. ................................... I\ \1 I' I .1 Person injured,. {lame o1. 'y; occupat1011, oate ~! Accide11J{-~ a./ l/V-,.._,..____pc..- A-'(,,____,,.. Location, I' . . ·ed in Min,', state where, If not llljlll • Supt Name of t.1111e . . • Age of Person ~n1ured, What family, if any, 1 /' etc C e..r __,_., ./.,/ 790 / Time Mine No. -e ~ 11 r ~/3 rrv-~ - /f I - 'J ~ f 07J Entry No. LJ , ;.__/ _ ( ~ ......I..__.((_;, Name o-F Mine Fior,nan _,l,_: 'r d•HoLU tong in employ, of. Oo., ? ~ 0 - ' ,... ...-1._.<- Marrie o Single - Room No. yg ~ ,..,_..,_,_ ~ 'o-e:.., Oo~1dition of Life~rircumLances, -f~ - _, CJ ,-_______, ~ ~ he temperate, ~ S c.:,-,_.J ~ d address of nearest lw111g Relat1ue, Name an Was he an efficient man, r c1 '../ _ Where and in whose charge Veft, ~~-----Name of Physician called, if any, // .;., rr ~ U Name and p, o. Adress of Witnesses. I I (Signature) 7 Title, �STATEMENTS OF WITNESSES. I He carried about three pound of powder ·;,ith him to motor car - ect while car going to entry, The ,,1ectric li;;ht callle under car to err the powder und explod"d, Since after he "as injured, taken to General, Hospital• Witness l \ x~r~/ Nishiya~a. l Sgd) T Ariga �------- oN pACIFIC COAL CO. rJ-Jls UNI _ _ _ • , F pERSONAL INJURY. I Mtne No . ..................................k. . 8up'ts No.................................... ii I f?TW0R1 0 r, ' ' if Person injured,, J, Cl-ro flame o . JJ'l,v~ occ11µat1on, . / n - c:.,/'A oato I :$ - 190 .1 Accifiept, t Y-'-j, • ~J (/-(,fTC/k • v,..--,-t-A.JV.;> J./ Time Mine No. Y I Loa11t1on, . . ·ed in Min<', stale w iere, E11try No. I Room No. -<-~~ ff 11ot lll)Lil !tc..o Name of Mine ~u~t: j::_ /3-1!. 0- c:--/~ .:! 'l Age of Person IIIJlll ed, ______ ~r l~ What family, if any, I ~j..,e.. c , . ~ t, ., HoW tong in employ, of (Jo.' rJ. . 1 address of nearest 7fumg Relative, 1d ::a::,; efficient man, :11 _, 0 Married or Single .1 Physician called, if any, //ame 0'J Co17ditio1! of Life or Circumsta11ces, Y~'7/l..~;r-e )?0/4✓ 7-( r- r,.- Y ~ 1 , -/ ,_ ~as :;:;~:;;:__~ O , K J L aA J ~ ,v/~-- t ~_ o(__ (Signature) Title, 7 / \ ....... --- /lame and P. o. Adress of Witnesses. 7 /J ;,,--,.__~ C>'C<__ ,-Q_.,:__<-, ( )·· J ~)~~·u) ./ ~ Where and in whose charge left) _;§;_ ~P':J Name of Mine Forman, 1 ~lit .1(,7 ' I �STATEMENTS OF \VITNESSES. Kine No 8, oct lE,1904 I wae running mw. trip aa usual v.,hen I run into some fine coal and rock on ~he ~r&ck which cut the ground from the motor I threw on one step more en t he controller and had just got throtlgh 1 t when I discovered t11e I. r61ley line had pulled loose from an ear I sto1,ped as thay hollowe:d -po"·der e;.nd just then I sa\"r the flash, It was ubout 6 or 7 cars from mv o J. ·;·.souleby uorot Uan r:.r R~ck r J-rings Wyo Oct 15, 1904 I was riding in on the m~n trip in n o 8 mine on ("aturday morning oct 15th about 7: oo a..m, "llhen near 24 room on No l ~nt ry inside of the 2nd plane there v;as an explosion of bluating powder in tht:3 car in which I was riding. My hondf: r.nd f, ce were burnC:ld from the flameo I believe the po1..dcr ,.1o.a a~.!"rj. e d by Ar1 6 e. a Jap miner and that it was concealeo ahout his pcrf on 0 ( Sgd) Tho:.i \'ii lde Wi tnees Tom Weatherly o • I �Form l:!.'1. p,\CIFIC COAL CO. -r.- r1 ( r, tn~ro~ BRSONAL INJURY. f{f.poRT oF p 8up' ts No. ••••••••••••••••·····•··•••••••••••• LJ person injured, / . I ~ #Jo&_ ... , /J • • - ~ t,l l.. ~ , . , . ....,... 1 occupat1011, . • Cl Ir- I ~ ,, nc of /I111 J • ,f p11te o, Acc1dcnt, toc11tiott, v /U-M( £2,/Vu 790 J 1- ---y ~ ~A • A _ d . ,1,•nr state where, .. ,re Ill ,1 I/ ,,ot Ill}' Mine No. ff ~r:A - .c_..... "-C....e, · ff,.,,, ~ r b Entry No. I Room No. I N /7 ame of Mine Forman, ~~. ~ M ~_.d__J) arried or Single ),:,~ r r _ :~~ - ~ .. . 17d Oo ttton of life or Oircumstances /1-e-v--e.--.....- :J // tong in employ, of Oo., / r ~ HoW d ddress of n.earest /iuing llelati$. " 7 Time / -------------- , of /,line Supt. 11am11 . . d 1person 11uurc ' Agco ·1 i+anu What fam1 y, , .,, Ii, }6;?~ , Mine No. -- Name an a was he an efficient man, ~ Where andin whose charge. left, ,. 1 ,f p11ysicia11 called, if any, I~~ 1~ , ~-c:~• ij...e..? cf' - · ~ ::7:;x. ' Wa he tempe • ,1:,-t- o-~ -v • .,.,,1_ / ) /fr_ '-..:.-.½ • ·! ~, '-:f.. te, .7_.A..iz-p_,~ • _ -- Name and p, o. Adress of Witnesses. ~h 'I 1/ature a1 extent of Accident, rd ~~ ~~ - ~ - (f.._,,_...,_;f- 1 ;,IL(,. (I ,?-<!...c- .......,_&(( --"-/-f~_,._;----;'J- ) f /'\ / // V (Signature) f!.o-c .rf £.,. P-; - , n . P ~ J ,,, 0 ~ �STATEMENTS OF WITNESSES. I I wae riding in on the man trip on Saturday rrorning when n...24 room. on 1 entry in aide 2 plane, there wa.s n fl~eh of fire which b ed r on v~ri<,tJB parts of the body. cause of the fireo I ru; : I do not knou the a Jo.p with o. ea.ck but Lhou ;ht he had apiki::e in i t . (Sgd) Fran1~ Leo came andF fo,e,., I / t /~ ~ 0- ¼, ,1 it :l I I ~ ¼i i. ~ · ~ ~ '<t. �l•'orm l 2:1. rHE UNION PACIFIC COAL CO. Rf£P0 R 1' OF PERSONAL INJURY. 8up'ts No..................................... --r Y~ £ .+ Person injured, Name O'1 ~ ....e.. occupation, ( ~~ oate of Accident, _.,, l1<J1-u . 190 Lj Time 7 Location, ll I~ ---3Mme No. p Entry No. . t •niured in Miw, state where, ~ ~ If 110 r ~ _fl, ~~: ,---/--- «1 Room No. ?--<,L- Name of Mine Supt. -.. <> ,-0 rl---~-~~••-1 c.- Name of Mine Forman, ~ ' 1 ~ (7~ Age of Person injured, '1 Married or Single ~ What family, if any, ----------How Jong in employ, of Co., ~ "')l-<-o-r~ Condition o Life or Circumstances, --------Name and address of nearest liuing Relative, ~C • . ~ Was he an efficient man, ~ , Was he tem~erate, Q '-1 J2../J Where and in whose charge left, ~ ~ J ; - - ~ ~-~ Name of Physician called, if any, ~ c?f'. •fr✓ -~~t:JF ~ Name and P. 0. Adress of Witnesses. (Signature) Date C-1-1,.IXJ.. 011 0~ / J# 7f(}y) �1 7{) 'ffIE UNION PACIFIC COAL CO. Mine No. ........................................ y REPORT OF PERSONAL INJURY. Sup't8 N0 . ......................... ........... c1H"~ f ~~ Name of Person injured, o~~ occapation, oate of Accident, (,!~ Location, . . r!P_~ If not injured 111 Mme, state whe1 e, Name of Mine Supt. I 19- !:!_:, ~ r 190 Mine /Vo. '-I Time En try No. [' / Room No. ~ e" ku--:e=- ~ ~'(__...- e /7.) Name of Mine Form~n, _ ~ , ~ , (1/~A_p Ma.med or 8111gfe /~ck_ if - . . __ Age of Person injured, -Y SWhat Family, if any, ~ -------How long in employ, of Co., / -;-,...__~ Condition of Life or Circumstances, Name and address of nearest living Relative, was he an efficient man, ~ Was he temperate, ~, Where and in whose charge left, ~~ . ,_..._.....__~, ~ - " - -.,__z ~~ Name of Physician called, if any, ~.;7~ ~' 4~ tJ? Name and P. O. Adress of Witnesses. /Signature) Date Od- I a~ 1711 ~ A,. ,~ 0,~ Title, ~ ~ �ST,\TF:MRN1'R OF \VTTNBRSES. I ... riding in on the man 'trip on ,..aturday morning. 2, room on Fo 1 entry, I saw a glash of fire on t r ... 1 e face nd t.ande. The trolley wire struck the cr.:.r nnd I slock from the snme. he had f' ikes o 'Wb.111 It which burned me sa.· a :ro.p with o. o.c " - nd tho" • u.ght Do not know bow the fire hup:penedo { Sc;d) Alex ~amps o:n. �- 1l'orrn 123. . '· ff!S ··'! UNION PACIFIC COAL CO. 1 __ __ _ Mine No ...............................~~..... , OF pJffeSONAL INJURY. p/!.'POI\ T (l(IIIIC O,f person injured, , ✓ 8up'ts No..................................... ~ ..,... _L - _ ., ~~~ occ11f}(!tio11, a, -..J._~t::/0 0/ltc of Accident, --~ ,\ 790 . ~ Mine No. Locat,o11' . .. ,red in Mme, state where, ~ If not u1J' Y. 'lame of Mine Supt. " .. -d Age of Person ~n;u,e ' 72 , 7 Time y Entry f'Jo. i . .,o-J{;- ~~ Name of Mine Forman, qo fi, PU,., / !J ~ Married or Single ..Z,,I _ Room No. ~ /,;(~ '+f-"'-< ? • What family, if any, ~ HolU Jong in employ, of Oo.' . . ,.f ~ ~(]on_dition of Life or (]ircumstances, ~ address of nearest llumg Rel6.tiue, \ Name and was he an efficient man, Was he temperate, _ ,,, ~. Where and in whose charg~ left, ~ ~ ,,___..e__ ~ $ Name of Physician called, if any, , .,e cf' ~ R ~ , Name and P. o. Adress of Witnesses. 7 Nature and extent of Accident, ~~ ( I I' (Signature) Title, �tl' o:OJN u~, ., /jtl I ' ' I I ' 1 �raE UNION PACIFIC COAL co. Form 12'J. --· -~- - Mine No. ......................................~ RHPORT OF PENSONAL INJURY. 8up'ts No..................................... Name of Person injured, occupation, oatc of Accident, Location, If not injured ;11 tAinr, state where, "'', 1 t;;, ' ,,f / ~ ~ r· ,\ 790 V Time / 0 JY. .h-, , Mine No. Entry No. t 1 Jf~ Room No. I ' ~~ Name of Mine Supt. / )(. . , . ~ Name of Mine Forman, , ,;p0 - ~ Age of Person injured, ~0 Married or Si6gl~ L r What Family, if any, -----How long in employ, of (Jo., '-' d-v C ~ aondition of Life or (Jiroumstanoes, ._____ Name and address of nearest living Relative, ~ . (:r)~ ( ; ; J - ~ ) was he an efficient man, __..e..A> Was i,e temperate, • •~ Where and in w~ose oharg~ left, ~ _::t;~ d~ Nameof Physio1an oafled, if any, 4--,, , I.S1- ~ l.f »,.~ , I~ Name and P. O. Adress of Witnesses. Nature and extent of llcoident, rl' J I I (Signature) Date C.7.IG.,.,, ~>•·Ufl. �174 }t'onn 123. r10N" PACIFIC COAL CO. t!IE UN - ' Mine No. ........................................ ✓ 1 F PERSONAL INJURY. R,wv1,r o 8up'ts No .................................... r~~ .1 Person injured, Name o, ccupation, -, 1 ~ dh O ,,·de11t, /~ -. 190 Cf oatc ~f Acvl ~~• Mine No. I ........__.____ Locauo11, . . . din Mini·, state w , re, If 11ot Jlljlll e Time 1 Room No. L.✓• ~ ?-7 ~~ - .1 Afille Supt. c_ Name of Mine Forman, Name 0'I . ,g),_/ /7 Ago of Perso11 !n1ured, "' Married rSingle ___ .,,.~ What family, if any, ......._____ .. . 1 ~ Cond1t1on of Life or Circumstances ~--- - g in employ, of Co., ~ How Ion tf ../?".-, .. /'ZJ ' ~ addre . of nearest liuing Relatiue, ~~ ./L n ,, /J -.-.vr D-1" .-d" ~ 98 Nameand L(.L-n ....., ~ " ' - ' _,,,, • Was he 011 efficient man, /I <fa.-~ , Was he 'temperate, L{9.,,:. Where and in whose charg~ left, ,.,,~ ~ ~ -~,._-e_:._.;::;f;- ~ (O'~ , A Name of Physician called, if any, ~. ~ --..e~ 0 , Name and P. o. Adress of Witnesses. •Nature and extent of A~oident, ~ ~ ~~ ~ ~ I ~ ~ ~ ~ /C , (Signature) , r 1-, o J-..C ~~ Title, ~ .:f~ �1,./5 uNrON PACI FIC COAL co. rf:JE --- RfS{'ORT OF PERSONAL INJURY. "Jj. occL1Pt1tiOII, ) t.. /.,; Date of Accident, / l,/.-M'v' L1Jcatio11, . .• ,red in 1,1111,, state where, If not 111/1 Name of Afine Supt. • • d Age of Person m1ure ' What Family, if any, ' Mine No........................................ v : 8up'ts No.................................... I J5,,-e..-o. r(~ ,1 Person injured, Namco, .. I ~t-~ ~~ , ~ a• 790 '-I- M' me No. -------- Time 7 / t? .fl. "ht ' Entry No.2 "'1--<'-r Room No. ~~ '<~c:2.6 V ' Name of Mine Forman, ~ ~ ,, , .. . . . . Married rSingle --------- _ _ ~t ~ r -: . Name of Physician called, if any, Nature and extent of Accident, \ (Signature) ~ I;>!(: 1 -;ro </ -.. / . Was he temperate, /--:;::::--,:::( I ---------- ~<~ ~ ~ #~- ~ Name and p, O. Adress of Witnesses. !....L"'1 -aA " Oo ndition of life or Oircumstances )z.c..._.tu\....4~ ~ HoLU long in employ, of Oo.' Name and address of nearest living Relative, • t LfJWas he an efficten man, Where and in whose charge left, ....7~ ' I , I �STATEMENTS OF WTTNRC::F:r.'<:: • . f; .A/,. •·t ':J ft( ~:11. ;2,- r Ir~(, 1,.,,1,r',/1. ,~,.,I, ;,1 ~ .J ~, U / ~ , / ?' If" ~1/✓ /t A ,;, "}- . .- - 1 . I :' I /( ;'> 0 j) ~ -< ~ ,,J/ t l,'.,L Z' /,. ,,{ (._ f, (;; ~ / f Y• /.J t't : /.I, I ·' ti! / , , ,t _,,? ·' /t <'7, , 1 ~ ., "' ,.•• i, ,ft U < "I /'_,: f I''f ;. i •, ,J ~ ,ry,v • (/.E . I I. / ., ~- 1 r.,,f ~ w /i • ,( , , ( ,' �• • t~:r, and ext , �rtl» 0 ~ro~ .- 111:•f'VN r 8up'ts No. ••••••••······················· ... t:11/liB OJ 11/J(ltiOII, ,1 :).Y Mine No. ............................. ,T."RSONAL INJURY. OF P J 1 \'. r;--- I f/fn,,.l[.A:.A. >A n ' d~< ~ 'n d .1 parson i11jt'.re ' 0cc 17g Form 123. p.,\CIFIC COAL CO. 1n~.IV //1 Accident, U✓- A!- . / ,j /.-.. z;L 790 f" Time Mine No. I Entry No. ootc ~, ) . / - - ~ ~ lucntron, d . f,fin,• state where, , Ii not i11jt1 re "' ' ' .1 r,tine Sup t• t.~ a~~ • pamo o, ' . • .d if person Ill}w e ' AgCO ., jlany, l''hat fam1 y, J ~ Name of Mine Forman~ •,..._.A ~/7 -;;,;; c.. rv . / v AA--r---1 U-vt/. :.:J 1 Marr(':1/'r Single ~ - Room No./ 1 I - /J ),-?,l ~ d_ •• in employ, of Oo., ~ I ' - - b ~ L-4a 00nd1t 10n of Life or Circumstances, Holll /o/19 ddress of nearest 1tutng • • ReI at.we, •'J,✓ ~ ,-_.,:_ e:tHame and a Was he temperate, efficient man, I e011 !YaSI ~ , 1 d in whose charge t, l'/herean • t I .1 p11ysioian called, if any, c_..,. /-y-,:-...__✓_,,__,_ --✓-, o- .,,...,, - L ' n / :it.-~ Name 0, cf ~ (" f p O Adress of Witnesses. flame and • • (} 141,,. and extent of Acoident, - 7 3 ~ c{. -<,..-., ~ (/ f J ,' ' l- ~= ....,;_. oL ~ J (Signature) 1 Title, I I ��ro.N PACIFIC COAL co. ftIE UN ·J r( 7 --- --.v OF PERSONAL INJURY. Mine No. ............................. psroRT 8up'ts No. ••••••••••••••••·· ··•·············· r 11ameo1 "· G> Person injure_d~_,i--r..,,,....... occupation, :_.,., c..,.-,....,- J ft--e-<-<- cf!...._,,,_ / # 1; l.../ 1 oatc ~! Acc%ent,. , , ~ e, , rt lOcat1011, l in Mine, state where, If ,ot mJ'" e :f}. 790 / Mine No. ~ • • . d i} Age of Person fr ''\ What family, i Time "< •- NameofMineForman, -· ~ p , l'f -. - ,, R oom No. tO ..:.:-c How tong in employ, of Co.' ~ ., . , _ _ ~~ ......-c_~ Condition of Life or Gircumstanaes, d address of nearest lwmg Relat1Ue, ee_~ . ~" t,,.?. Name an ~ ~c) enicient man, was he an '11' ; ) _p I/ Was he temperate, Where and in whose charge I , . vUA--L .9t' J /, \ o / 6 2#Y/:l./- cLL_ Married or f fndle ' ,y, I Entry No.ftu_ S: ~ 1wneofMi11e8;~, - ~ 1 o-, __., ~ - -~ -;JI' e_.e..., ~E J 1 , ~ Nome of pi,gsioia11 called, if•~ ~ ~ , -~ V~ , lame and p, o. Adress of Witnesses~ :~, Nature and extent of Accident, >'YVi. ,\ ~ </- ~ o(__ :,/4 J r (Signature) 1 Title, �. .. .. ... .' . �81' ,\'T'RMl<":NTR OF WT'T'NRRSF.8. ( I • .. . -. ,. 'II , .. ..... ,r. ,. �1 1'"TN(ON 1rIE u R,spOR Form 123. PACIFIC COAL co. . T OF PERSONAL INJURY. ,Eperso11i11jurewd ,. 9=J ... Name o,. ) ' h ,( / , (: : - 178 ! Mine No...............................~ Sup'ts No. .................................... ~~rJ- ::l. -:,__ 0ateoJAcc1x·d II~, )/ : ~ . •" /v-z_-vv<-ije Location, . · ,re in Mine, st e where, If not111J1 - ~ ' occupat1011, -1 UPlJ · I 190 '-/ Time Mine No. / Entry No . Name of Mine Supt. ~ rn/f Name of Mine Forman, Age of Per~on ~njured,Jl/,;f,.,/:! ., "i-1, IJ . /} ,.. Married or 8ht-glt; 'J11. ~ ' - - - < • c,(., What FamJ/y, if any, j . , ~ c::::....,~ ~ Holli long in employ, of Oo.' ;2 {J <!::f-e-. ~ Oo11dition of Life or Circumstances ·n RetaUe, Name and address of nearest~iu ~ ~ ~ was he an efficient man, Was he temperate, Where and in whose charge I t /~ >/ -e r ~ 0 Name and p, O. Adress of Witness- J r , ~v . , /~ ~iJ ~ J I ' 0 II Nature and extent of Accident, 7 ~1/l.A.- cu { ; ~ (Signature) L~ , I t I �-----r-,..~,... Uo 9 i' ine Oct 2 6 th , 1S' 04 1n.Ju.red n ,;,n • i-: ~ to.temont I t11.~o ridine: c. l oc .d<-d t r j p d ovm the i,la.n e 1.~nd the engineer c;cwc L<J1nc 1; 1 ack n 1,e c..n ci I ov..: r b a lu.nccd myr- elf u.na. h n1ioud f4CCi dent nndfel l off the trip ~, 1 0ft }· h c 11l c'u r. The 0 ·:u..a no o n e to hlame f" o r the ,•l �O~ pJ\CIFlC COAL CO. .:- ( T~l • fl rJ> - - - , F pENSONAL INJURY . •JIOR1 0 , N) ' .1 Person injured, p/4,ff, e_J ~ th,,/ uame o, occ11pntio11,. t/(({h ~ -< lo 0,1/C of A~l~o/' , ~U/4.0Q cation, V vt,rr:Y, L0 . • din t,Jini:, stat' where, If not 111}ure Mine No. Y' ~ •..f2 / o,f Mine Supt. t:;::/~u r-- / //(1(116 ••. d f2 '2.. 1 Age of Person : 1J"' e ' _______., What family, if any, at i· c--c..~ . ~~ d address of nearest huing R latwe, .1 Physioian called, Name 0" t, any, / Ettt-,,y No. Name of Mine Forman , 6v L . /. fl {2,,-~/4..-o---vt-<-<!_ kl--/ 2 c......e. o(_ , A, er ,/ondj/1011 of L1f~ or Circumstances, /4-~<4,,(.~ Was he temperate, Name and p, o. Adress of Witnesses. Kalure and exlent of Accident, ¥ J~ ) c{_q_ ,.-- l f\../ ___.... (Signature) 1 Title, /' lr-7__ ,,...;_'-'t--')j.. e....e__ U .. 'Jl?o-n.-/~ /J '--<-o,,<.. _ Married o • Single HoW tong in employ, of (Jo. , Namean !Vas t,e n11 ejfioient man, Where and in whose charg, . 190 ' / Time - t -"-<-L-~o-(___ (/ . �Foi-m 12:1. ,rrO.N PACIFIC COAL CO. rFIB V.... _. _ OF pJSRSONAL I NJURY. J8() Mine No. •••••••••••••••••••••·················· Rtf'ORT 8up'ts No.................................... if f/(1/IIC o . Person injure<!, Q 1~ /V/JY , tlad. . J.. t,vvvl-<.r . . occupat1011, I ' tc of Accident, oa . V,J-J1-10..-~u_ a. ~ l j ~ •- <J1hA-A,,vVL . LI 790 7 Mine No. Time fl ; 0 t.J 1 Locat1on, . . red in n?mt, st te whe1 e ff not ttl}U ~ j' 4W ~/1-U cfJ rY2A. Entry No. L/ f ~ Room No. Nameof Mine Supt,Ju> ,;-,,,; .( Name of Mine Forman Age of Person :n)ltred, ~ Mar, ·ie or Single What Family, if any, ~ S U 0 1 Hotu Jong in employ, of Co.' • C,l,Lx:1. J1 dition of Life or Circumstances address of nearest liuing Relative, ~ n ?YI ~ n ,..,. ' (lame and ...,.__~c... a__ Was he an efficient man, ~ ~, Was he temperate,o Where and in whose charge lf!j, ~ • d-Nameof p/lysician called, if any, o/___ (f #\ /lame and p, ·u a,. · o. Adress of Witnesses. Nature and extent of Accident, Lr t c.a..J_ -<--<.LZ. . ft ~ ( f ') )J • (1 )\\t· (Signature) 7 Title, �'l'II1~ UiN Form 12.1. roN PACIFIC COAL co. _ _ ·,! 01 · _ M' N JI.. O 1ne o. .........................................' / . / , OF PERSONAL INJURY. R,woN1 . 8up'ts No..................................... t°~ ,.; Parson injured, flame 01_ QccUJJClitOII, ~ ~ .~ ~ ~ . • ~ ~ · ta of Acoident, ,, .::? -.:? \. .7 790 Y- Time /' Q .,,-<:/• /4..t I On . /JP_-/_/.] .,Ju,~~Mine No. 11 7 Loc11t1011, ~-~- -:::_...-Z:~_~T,... Entry No.;;? <r ~~Room No. /'f!" ~ o .• ,·ed in n?in<', state where, ....______ If not Ill} 11 • 5- 'r~ k~~ ~ Name of Mine Supt. . ./L,C Name of Mine Forman, Ac of Person injured, / '7 -;--< ~ /Vlarried~~g;e~ • g ;.; What Family, '1 any, H tu long in employ, of Oo., -.:f • ~ Oondition of Life or Oircumstances,,,1 ' ll:me and address of nearest living FMatiue, ..C ~<..u..., (A)~< , # ~ ;;j'.. . was he an efficient man, Where and in whose charge left, Name of Physioian called, if any, (.:;;:?~ q f Was he temperate, 17 ~ <>---"~ ~ {1 R~. ~ . /lame and p, o. Adress of Witnesses. Vature and extent of Accident, 4~ , /?-, ~ ~ ~ - - I }~ ~ r- ~ Ll. I ,· (Signature) ~ <:-1.ir,. .,, "'"•011. ~ 'I Title, ~ 0 �STATEMENTS OF \VITNESSES. .... �.. K Mrunu.i vm.s \'mrki n, •; .:;i "\ h me on ➔11:e J.8th , ;;;_y of Oc tc1her Ro om ,,.,ii. .... , 414 ontry 10 mlnee Hu \.JU~ ~.nove line; T,he machine i.: lack oxrn.y from f ace of room an d 1r.0 c0al c1;ot loooe u.nd. f e l l 'f-TO ont:, Lo h l 1tllle i 'L wus j u!,t on YLi m c nu.s ing in.j u ries. o.cci d <; nt \ I j �-, 182 TroN PACIFIC COAL co. r1IB UN ---· -;,ERSONAL INJURY. Mine No......................................... L,/" Rf-WONT OF 8up'ts No..................................... • • 1·ed .-F Person /I/JU f/(l/118 o, ' :;?"( ~ )// ~ ?. ~(_ ~ occup<ltion, ~ - ,, 8' ~ <rgo J Time ,F Accident, . . I / O oate ~J ~ ~ Mme No. ,h:1 Entry No. Locat1011, h ( ti" ~ . . . d in Min<', state cu e1 e, If not ul}ure ~ ,j ✓ .d '>- ~ , vv1,., 1/ Room No. r;:';;/, .;;;2_ ~ !,fine Supt. Jl--0. ~ 0 Name of Mine Forman, c:76~ (lame of , ,·111J·ured ..3 : . married a;;g/e ? - z - 4 - ~.,. .-n Age of Pe1·so1 . ' ~ · - --- ~ at family, if any, ::? .. . Wh in employ, of Co., ~ Oond1t1on of Life or Circumstances, How long . . R I .. ddress of nearest //umg e auue, ~ ~ d Name an a ~ / man, Was he temperate, was heal/ efFioie11t :JJ' ~-. • £ Where and in whose charg~ left, :;J O ~~ ~~ ,F Physician called, if any, ~ ~ c;p--._..o--f, t1ameo1 ~ J 6 Name and P• O• Adress of Witnesses. Nature and extent of Accident, ~ o ~ ✓--J-o/ ~~ fy 7 ~~~ (Signature) Date 7 f o t/ I ~ ~ :2 ~ �■ STATEMEN'fS OF WITNESSES. r· J' r I / I ,: -- / ( .. ' f . ....... \. ,,,,..r ~ .. I I ..,1 p. o. Adrt 1;';• I ' :• .J I I . '' ' .,.,-:.· ; "t /( { ,_ :' , . ... • t.,f (~? I • .. ..../,, . I! ./ . I .) I ' C •i • -f I ., ' I ' .' -' ·, C. j. .. t l. •·I'~ I I .j. I ... \ ,' I ( i , lJ_.,., ·"' / I • .; I. "' .., I r ' I ~ r• , . ,. .... .., I.· , t. _, ~ , t.r,-:_! ....._ I 1 {., ...,,.. - • V , I f • I - ·- ., -ti,1\..--. . ' ' . ..' I ,• t , .l -- .... / .. .., .I \.\.'- L. \ : .\ ' . . .. ; /. ,I } ,,,l : I I I .!. '/ - .. . .~ .• :/. 1 ' .,• -: •), ~ IT !4 ,......,- .I , ,/4 '- \.1: , ,. :.. ' • ''l ). - . ., ..\, ,_ ..'.: ~ ,···, (../.. • ----- ---- ; .. ~ ....... - - " /, ' , ! ' ..'(,..~,. ~-Yo '). . ,.,--- f ' I I , I .. , __ ,. . I :,,, .. I , I r; ) ' ., I c...,._.._r:J Lf " .. · c' C' ,{.., ! ,._ t t.. .... ~--,'I· .. f .. t{ . ., I ..., - I If" ....._ .-· :~ ·- .,,,1~ / ' ./l .... , . ' t ~ ~ I'' ' -:...- ~ ~- ;,' I , ;i X.: 'I' ,·) rl ,. I ·-·- ,(/ 9 ) I -'j ..,. / .. ., 1 ( t.:ild ex/Ent of �183 Fonn 123. UN fON PACIFIC COAL CO. tJIE _ _ __ Mine No. ...................................~ , , OF pHRSONAL INJURY. RfWOI\ 1 8up'ts No..... .............................. 4. ~ ,F Person injured, Name O'I ~ occupation, ~ 46 oatc ~! Accident, ~ ( ----x.An.,. ~ ~ Locat1011, ~:-;-~ •niured in Mi11.-, state where, If 110t I 'J /lame of /,fine ~u~t. £ r7 790 Mine No. ......__ _ __ ~c:,.... Time Entry No. Name of Mine Forman, Room No. SZ-,e_,_. Age of Person IIIJUred, - - - - - ~ ,y ~ Married or ft/g1e --~ ~......_..-..rz_--c.p l'lhat family, if a11y, Hoiu /011g in employ, of Oo.' ~ t" ~ Condition of Life or Circumstances, --/lame and address of nearest liuing Relatiue, . ~ ~ ~c~ Jte.w ~ Was he an efficie11t man, Where and in whose charge left, ~ Name of Physician called, if any, /P,-~a....-~--........ Name and P. .L . • , 1 Was he tem-;;r;;;:---r~ 0-----4 o 0 o. Adress of Witnesses. Nature and extent of Accident, .. \ I ,· I( I ,.l 1 I I i I I (Signature) �STATEMENTS OF V/ITNESSES. �l,'orm l!lJ. raE UNION PACIFIC COAL co. Mine No. .................................... ~ •T 01" PTtRSONAL I NJURY. ()J NIW \ Sup'ts No................................... /tarn• of person injured, h~ .~ occupation, oato of Accidont, ~ Location, ~( If not injured in Minr, sta a ,ere, 790 ' / Time Mine No. 7 ---- < ,#-LA , ~ parno of Mine Supt: <... Name of Mine Forman, _H 6 Age of Person I/IJllled, .;::;. -✓__.AC'--"~.__...,, Married~~le --~~---c+~ l'lhat Family, if any, How long in employ, of Co•• ~ 7" ~ Condition of Life or Circumstances, ...___ __ Name and address of 11earest liuing Relatiue, ~ . ~ ~ - - - JJ ~ , ~~~- ,__~ was he an efficient man, ,, c..,, ~/~temperate, 7/~ C} • ~] Where and i11 ~~ose charg~ left, .?f,.::'"""V.,_._..........._...._., ~ - 4 ,. ~ ~ ~ ~ ~ Name of Phys1a1an called, if any, <>./l''-0--'\..li!,,__,c~ q ~ - • -, ~----- 7 -5' I.(. ~,, • Name and P. 0. Adress of Witnesses. ~l 1\ t{ ,(~ I \, ( lit ~i Nature and extent of Accident, 4- ~ >\, '~,,L 1 (Signature) ~~ a.-,y ~ ' �STATEMENTS OF \VITNESSES. / 7 '\. , I I . ' • /( I • ,-:-'7 . . _./ L ./!; ~· ~ ...-t:., I ✓ l ' '• .1. , . ( - . /{ .... . r .I. -'U... /,. / I . . . ./. _, r,1 ,,,.,1~ ; -- .. <._ : , / I ,,_ ~ i i . .J/ • , ·1 ·r ,, ' �.~, o~ tH'E UNION PACIFIC COAL CO. M" 1-.. C,e) 1ne No. ······························· ,._;.,.---- •J>OPT OF PERSONAL INJURY. N/1 \ l I 8up'ts No. ·····-········ ·•····•••••••••••••• ~ ~~ /lct/llC of person injured, ~ occupntion, onte of Accident, ~ ~ R ~ . ~~· Location, . . , ff, , ,,ot injured 111 f,f111P, stat 1 fla ' me of Afinc Supt. Age of Per~on !njured, lfJ,atfam//y, if any, -; I ... ., ' .'' :J... \ ~ ,·•• t I he ·e, Mine No. ----- ~/ ......,,._ Time 7 ---- .,. ~,✓-;:;2. • ~~c.. / 7 .___ _ _ / 1 Entry No. • ~. ' Room No. Nameo+rt· ~ 11 'J 111e Form~n, . Marne r8ingle .:::t- was he an efficient man, Where and in whose charge left, ~ /lame of Physician called, if any, c::::t=;> ~___.... ' ~ -3...,' ~ ~ ~ ~ n ..,,,,,, 4-t HoW /"gin employ,,+of ao., . . ~ Condition 0 + Li£. • Name and address 01 nearest ltutng llelaffefe, ~ 'J ; / or C1,rcumstances, • r~ • 790 ~ ~(..e..- . R O ' ~ ~,.,.,.,. Was he tem;erate, ~~ a- ~<??~- ~ Name and P. 0. Adress of Witnesses• .,, t...!!r. t. •I ~ Nature and extent of ~ d e n t ' _ ~ l'~ __ c- _ ~/ , ,. -~ , -~ ~ ( ) ' fl." (Signature) Dote �STATEMENTS OF \VITNESSES. \ I , r -: f J Union l)o.ci f i c Cou.l Comp0.ny , ]0G.r ~ir:- I. ,,.. • 1(;; ,,. · ~ c•c s,.~c.rp0'.il:Li •: , Olle ·J':'Or top of Ylrop/ ,,,-1Le11 I • l:' Y\r o,, it .I.' I Ii 1904. ( Si _?'TI 0 d ) ' .., • ; /• �Form 1!!3. u~roN PACIFIC COAL co. ,-r1B 1 - - Mine No............................. oF pJSRSONAL INJURY. f?JSPONT Sup'ts No............ ..... .. .1 Person injured, Name o, occupation, ~ 't t o(ltc of Accident,/"Z> t) . vr P"C4C:: ' \,\t•· Location, . e, state wI ere, . . ed in t,1111 :, If not tnJIII' ,ff &• ' / 3 ~ 790 t/ Time / dl /4. ?/z-< Entry No. Lr Room No. • Mine No. ..,______ _ ~~ I ~ ~ 1 iti11e Supt. 7--e....o · Name of l't1ine Forman f,,,_ Name 0l . . d ;;~ , ~;-:-v- . /J., Age of Person :n1ure ' ..______ _ ~ Married cu. Single ~ ~ What family, if any, -... 7 HwJong in employ, of Co.' ~~ ~ Condition of Life or Oiroumstances 0 nd address of nearest liuing Relatiue, O ~ c, / / 2 . • ~ q 12-. Name a ion ~ was he an effioient man, • t l1?t•' Where and in whose charge_ left, ~t 12 . ''Name of Physician called, if any, o1C,,, ,, c:r-jt ~fif"°, =- /'I"~ Was heCfemperate, G ~~~ c;p ~~?) "J<R----J?. , ~,...__,_..:._ ' )¼ -,-- ~ - • ·I(,• ' Name and p, o. Adress of Witnesses. a• ~t?i,~. I' Nature and extent of Accident, x::· ~ ~, I (Signature) Jfe �//~/lie occ~P I gate'. ii' , I/pot 1;11/lle Af 01 1~Mt• ( ~ ::irtJ-11 chiJ.d ) by tio!ng otrv.ck ·iJ~i -.1 :r··,.u-;.fV:?D.~J HDIU ,, come • Union fneifi c Coul Oomp~ny. r :...m rn::;yl c;y-od by T11e Vn:v·-,-._ I uo:tfit, GocJ.."l Cc•nt}h·:ny ._:fl t;. cJ.e:rk 1 •!ash• I l, I• Wbe'c 11ame t Nature �rt16 vNr l - - - 1tiil. • ~ Fonn 12:1. ON° pAC[FIC COAL CO. - Mine No. .............................. , F PERSONAL INJURY. 'lh'pVR1 0 8up 'ts N0 . .................................... . . d JJ,f./4,,,/L_ ~ £ 1 . A . . . , ' - - 4 - of Person 111~1,rc ' . ·~\• l· 111mc o.. '-\.. c.. ,._.._(J ' : 1.cupotion, oo 790 • ~ .1 Accident, 7 •• c.,c..<...U "" I . ,,. i) () u' ( JI.. 11 1,,ti: ~J ft ~v-,.- 1... <A.}? \.l'\ , .orat,~ •. d in Min<', state where, '\;' 1. /not //IJUfC 'J Time I a Mine No. U ? k °'-"-' e<>-<-•-/4 ~ g ; /J ~J-L..-<._ Entry No. Room No. )1-o---LA-:LJL -#=- -<} 1/' -~ :ti' Name of Mine Forman, of t,fine Supt. ·., vamo . . d Married or Single ~li ~ ., Person 1111ure ' ,(:Q•·t fgB OJ . ,,il;,:' ¥hat family, if any, ' long in employ, of Oo. I Condition of Life or Cirouznstnoes, loW t 1· • RI t· ·7 /J _;__/ ddress of ,ieares wmg ea 1ue, Y~t--z-<--<--<.--<. , ~- LZ<-e-,,:i'l famean d a ~ l.!~ (t , 11. he an efficient man, /;Was he te erate, ,. 11 ,,as 1 ~ •!; din whose charge left, 1 -&.• rJ/}//,,,~ L <...~ 1t U' Where an . -./J /' 1 f ) /JI) 1 "' ''l ,. ,1 Physician called, if any, ,1 °\. -.,,. v c..c.... c.....c,C ) / tP Co-u-e.. ~ V - v ~ 'j~ ,,., , , 0 •.'.:Vame ~ ----3,) 1' • h~:.l d p o Adress of Witnesses. •Mame an • • .;,J<,1~ ~ gilt r.t~ I ' 1 ,1,r, l .. . •, • • . Nature and extent of Aooident, U kc,,...•. ... h(} •f"...' t,• ., 1 I :, 1, ' . I I II Cause, (Signature) 1 Title, �llr. Reynolds ~as injured in #34 room #5 entry #9 mine uhil e unloading a mining _machine and moving same to face of room in the flllowing manner: When unloading machine from truck he neglected to suff iciently block the truck whee ls thus a ll0\7ing· the truck to run back when the 1:i ma.chine slid off, leaving.the machine unloaded on the room road several feet f rom the fade. In order to move the machine foreward more easlly he placed a jack pipe to act as roller, across the track under rear end of machine frame. A piece of r a il used a a skid under rea r end of machine when machine was in position to work had been properly placed. He then proceeded to bar machine fon,ard when it dropped off the roller it fell on the skid. Mr. Reynold's big toe was under the skid. E . c. Stevens Eye ' 'fi tnees . I ,... (Signature) 1 Title, �1 ~ tJNfON ) ,,oNT 0 PACIFIC COAL CO. .1 (.)t)8/ I, Form l:?:l. - -- Mine No. ......................••················ ✓ F PERSONAL INJURY. 8up 'ts N0 ..................................... .1 Person injured, ~ ,,,c.,,,vr, Q.,.,~ co, /l . ~~ • -tion /J 11...--~..........~ •pa Ac~ident, "Y'Z,,,;,-:,~:'. J..- ~ A::4 190 ¥ Time <? C?, Y/1 , 0 •/ /D y{e, r1,, .,,.Z<-',P Mine No. 9 Entry No. ,.r lion, V~ ' ti . ·ed in Afinr, state where, % } Room No. ! >l U>]Uf ,e of t,fine Supt. ..A_;_,_ • , ';J:.., C1:l-e--lJ.. Name of Mine Forman, ~ . ,1 person injured, .S-tJ -J~ Married or Single o, n,} ' t (oc..)J t family, if any, ,...-1'.1/ ~ :long in employ, of Oo., I If ~ v Oo11dition of Life or Circumstances, and address of nearest liuing RelatYue, ~ J:!:f/vi,r ·-'K._ 18 . he an efficient man, /11..-uWas he temperate, ;,e and in whose charge left, ~ - ~ _.,. ,,,,.~ of Physician called, if any, GP, d'r'--, {Ir:!~ 'd:., , 18 ,e and p, o. Adress of Witnesses. ' cnt:fo, 1iJ I -ure and extent of Accident, /. (Signature) 1 Title, �,. To T. A. Jamee. This io to certify that John Smith \7hile \1o rki11b on No o 9 Dump on the 29th d~y of November, 1904, broke third finger on right hand trying to uncouple c~r rri th a bar v1hile trip was moving slow e.nd end of bar etril~ing corner of Weigh house catching his finger. door v,o.s open o.nd could not uncouple c a r \7i thout -Car bar. Ol af Rose\"10ld. .I I (Signature) 1 Title, �F01·m 12n. PACIFIC COAL CO. g UNION_ _ _ oQRT Mine No. .....................................V OF PERSONAL INJURY. ~ J2f~ -~ Person injured, ~~~- e OJ. ·pal/OIi, ·dent of Aaa1 , /)/l,Af"~ ;J- o/ 4 ~ , ,,e/.,;h.,.,_,:.,,_,,~ / •• ~ .. t·ed in Mine, state where, '. (/0/1, Sup'ts No..................................... 1 !Jv--~ 1/l ~ /.' f '1 ,,~ -;:;:.· / 4 . ~ d.,,, .F A ?ine Supt. _,,,v._,.~ , , • ;r. ,o OJ II -::> 7 • ' v ,'l AvL4.,, of Person m1ured, t family, if any, _,:f:;;;;ff L J-) ~ : tong in employ, of Oo., G ~;r,,-z,.,n,,vT ?/ 14address of nearest liuing Relatiue, ~ 10 and he an efficient man, (l/ ~ 1 1re and in whose charge left, J! . / cP, '7-rl , Entry No. Room No. ;,,n.//Z/ / Name of li?ine Forman, ~ ~ <-J J7. . ?~ Married or Single u:-£ Condition of life or Oircumstanaes, /.,'? ~ ~ tJ ,, o· M , _g.;;_,,.,,_.,,~ 118 lf-; tf- 0 Time <J Mine No. _J_ 1t 111}11 190 ?-r Was he temperate, -v ·,.Ct--vr.., 1 of Physician called, if any, ne and P. o. Adress of Witnesses. ture and extent of Accident, ~ -3'~ ,,(/}/ ~.r...-J , ~"7~ rr ✓ia, (h~ ~ -<--'~ tn-v ~~ I if~ -,.<.-, ;l f (Signature) !lite 7 Title, �For111123. pACJFIC COAL CO. 1116 lJNfON _ -BRsoNAL INJURY. ,r OF p Mine No t J?LipO~ 8up'ts No..··········· ...................... .1 person i11jured, /J,1111C OJ '0/1 onte .1 OJ ,. ~ (,~ occttPtltI I I /] Accident, l.,<l c.--, -, ,,/ . : ~v 79 0 'f Time Mine No. 7 r 'D ~;,,, ,,<,f,,,fv~ 1 .. ~ .J_,, (011 Jv• • t i,;en t ' d . Minr state where, If not injure m , , { ,_,,tr , .1 Mine 8up t• ./' r Entry No. Room No. / Q-'•~ {}- rJ -v. -< i..4-,r - - - What family, if any, 3 ...-,,;,~ • L T.AA--r.-,"V"".: J V I- , /lame OJ • • ·ed .1 Person ,nJUI , Ago OJ 190i · ········································ V Name of Mi1"F Forman , Married or Single - tong in employ, of Oo., How d ddress of nearest liuing Relatiue, f{ame an a an efficient man, /1.,/..v.L.,, was h0 ( d in whose charge left, an Where . . ,1 Physician called, if any, 0 11ame ~ /4J W,/-~ A Condition of Life or Circumstances, ;u.,,._, ~,,_ ~~ • tr-t., Was he temperate, 11-/,<4(/ /lame and P. o. Adress of Witnesses. j Nature and extent of Accident, ~4 ~ ~ /Ar-t' r11~ - (Signature) ~ 7 Title, � https://haylibrary.cvlcollections.org/files/original/5f33b2ddead535e9b9bf03f1999b40eb.pdf 79948fe8d95b2bae66ccb55a647f41f9 PDF Text Text l VERDICT IN THE CASE OF J • MORINAGA • Rock Springs , 't'Tyo::ning o Doc" 16, 1904: o we, the Jury duly impannelcd and o~o?n aeco~ding to .la~ by Mike 1• J)&Jlkoweki, Coroner, in and for Sweetwater CountyiState of .Wyoming~ to i nvestigate into the cause of the death of one J a Morinaga : after yiew1ng t he body and .place of tho accident and hearing the test imony ot wi t ~aaea • DO JIJ'J>: That t he aaid J'. Morinago, co.me t o his death a.bout 3 : 30 I I l o' clock P. x.»eo.l5th, 1904, at tho \'iyoming General Hospital from 1n.1ur i es rece1Ted from o. fall of roe!: in no. 3 Entry, Mo. 2 Pl ane, of Kine No . 8 Uni on Pacific Coa l Company of Rock Springs, Wyoming. 'fe the jury find t hat J ., Morinaga. me·i; his death by carelessness on hie own part. (Signed) CoAaShoddon Joseph Berte Frank Ransom Presented .t o me thin loth day of December, AoD o 1904, in the t own of Rock Springo , Wyoming o Hike J Q Dn.;,"'l..l{o-crslti (Sgd ) Coronnr.o (} II , I �t, t - { ,. r; l n J " : t. 1J" I ' :i u c :. • c· o f I 0 •ll1C. .• C.., .. .. -.. ' .,_ • -I l- , I.. it, '! I -~ in,J ck ,'f1.' 1. ,.<·rlt .. n nc ri J., Ylt.:.i e;. ,.. t c ·: ty '? c< Ll .i .r c. rtn ... r-·-~:i._, l ,. • • c·ri n ·.e;,.. •, t h, t. . ( • 1. J:n c r1c.;. :ic ~ o ";hf..: :·1 c,~ l.• ,, :· u , .'f •l h· tl h :Jt 1_{1. i:.... o l• on•:~ , '·~-~ i·l.1 • 1. • "'·; • , "'l L, - - , r y i.o . u i, . i."'Oj., j n ,.n c ' f' •• Jv1 · l 1! t l ',.; lL"'- !,! ,~v l :·#11 ) 1'.t ·- ~ •• u : i n ,juc :u o \ ·:, ). l; ! ~'h.--Y zn,·., -.}-c, :('(,( f .. , ' 1 1; I :1Hl · .,· . ._ f_ 1,{' c..t' I:: 1n1! . r •:-i :., t:i._ 1· _•·rL 11~r ,cr:1c_c., j t .,11 i1 re·. ''n< j,,: 1r. ·r...: . 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Mine No , ...................... .················~ 8up'ts N0. ....................... I person i11j11rcd, i -yyz;,,, u:A/ • of 1 . 1liOII, ~ a, ??1, ~ I ·f Accident, 790 If Time f j ,' JtJ Mine No. g Entry No. -3 Q/ , . :~::n, din ~f,fin el',,st at e~u/1er·ecr t , tin111'c 1• . ,oJMi11c811J)t, ~ . h ;! person '.njured, -3 1' ] 1tfamilY, if any, ~ ,:.•.:v-t,.J.-- NameofMineForman, ~ , Q3. ( j ) ~ Married or Single "7,r,~ I If- ~ Condition of life or Circumstances, 111an9 address of nearest 1·1umg • Re u t·iue, ~ ~ • d ,; an 1 1 Jean ffioient man, (l../,v.J~emperate, 6 Ls ~ndin whose charge left, O CW~ytn-..~ ~ n...vi,.J ~L.'7':. P ~• U TIU. ~~--· r·eof Physician called, if any, Ur::-r ~ ,l in employ, of Oo., ~ o p:,and p, o. Adress of Witnesses. (Signature) 1 Title, ••• �ACCIDENT REPORT, U.P. COAL co. f .FuZicaki u:", B working as a miner on /f3 r.:ntry pillar in the mine of 8 rrith J. Mo rinaga on the 16th of Decembor ,1go4 as usual und injured his fingers of right hand by s ome stone falling. vms tr;vinB to escape but failed. Agent & ! nt c rp:reter R.Nish iyruna . .. (Signature) Date 1 Title, At the meantime he �~, • :, ~:. Form 123. '(JN[ON PACIFIC COAL CO. rJ-J» 19:3 Mine No.......................................... - - --- ✓ , OF PERSONAL INJURY. l ·pOl\ T fU 8up'ts No................................... . .1 Person injured, ;?T, .:3' ~~ ,,,.,~ O 1111111eo1 occ11patio11,.' , t7 I.'. - . I 5' d 190 tf Time if Acc1ae11t, ~ I ti/JO oatc ~ . (R,,q-&fe- _Qf ~~ Mine No. g Entry No. 3 cation, Lo . . d il1 Mini!, state where, C?, '7,,-v/, RGrffiFmJ. a- <P~ If not nljLIYC (lfine Supt. //ame 01 . Perso11 in1ured, Age o1 . What ramify, if any, H long i11 employ, of Co., ~ ~a/2..d.ocu d address of nearest living RJ/atiue, _x:j~ {lameafl was he an efficient man, ~ Where and in whose charg~ left, flame of Physician called, if any, rW NameofMineForman, CB, G ~ , -0f~~r Married or Single Condition of Life or Circumstances, {; , er~ ' ---y~ ' /T) ~ a--e .--<1 -1-,;;:.µd b ~~.,fl.A '~...,.._.,L. / U ~ - -/ ----r Wf:r.s he temperate, ~ ' V,'r {) /lame and p, O. Adress of Witnesses . (Signature) 7 ~. Title, �STATEMENTS OF WITNESSES. (";I • • I • i ... .. ( 1 . i •r, . ... i ~ I, ;- " •• (: ' ,. . ( t. { -. ! ~ '.' r· ,.l ... l.. �STATEMENTS OF WITNESSES. • :, .,. .. , - •f t • . .... . ,. . .- .. , .. �ll'onn 123. N pACfFIC COAL CO. cJNlOl 'fJ•JG -,r OF pJSRSONAL INJURY. 194 ,,: Mine No. .................................. ~ 1 Rfi/ 0l\ 8up'ts No. .................................. ~Ge .1 person injured, Hame o,. cc11pfll/OII, ,..,,,() - h L11cation, .• . din t,1i1111, state w ere, u---- 190-4 Time - ~ O 01,1Accide11t,/Jf ,,,~ _~ o,,tc: ~ I/ 11ot 111jlll e ' Mine No. / ----- / --, ~~ Nameof~~ f r,fincSuu;;f~t. . , -3 / //{lf)IC O .. ..., -< •• -3...u ~-~ Entry No. t:l_ Room No. I ..________, J?f " " v " - ~ ,0 • • • Age of Parson ~n ' ~ , "°__5 . ~ frfarried or Single ~ ramify, if any, ~ - ~ What ri 3 h ... long in employ, of Co.' ~ ~ Condition of life or Oiroumstances, Hoiu d address of nearest liuing Relatilfe, ~ f7'q__ a _ _ ,. ,__I} m,. n " . ~ Name an (7 .... . , ~ ~ was t,e an efficient man' ~ Was he temperate, ~ ' nd in whose charge left, 0 J' ~ O • a Where . /lame of Physician called, if any, Name and P. o. Adress of Witnesses. 7 ~J. ._X.{d _o . 0 ..., / ~ ~ c::{ ~ / I j ,. 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'-l o ~ '"'•J ..n:.J • ,J•• fttom-. n. Y Qtir . t.hono t r:1,!1!i :'!..l: "'vl :::.t ~-dnl) 1 ('\ You OA-> (!llitll ;:'\. ( 0\1 :i!ffn go i nr, V l i..- ,-J ute:, •~\ i {i ~i~O? t'ro1:1 t lmt 1.ir:.o ~n t ':1,,r o \;~r,; r,.:,n c o.ii,:., out :.ll -th:., t i :;0 0 Ly l'ui r--Jur<J;'. q iiott ortun tlO th0Bi, t, l-i l)O C C l :."o. ;l i.i."1c..;•101ou? I k .c d 'i)'K t.hc y :-,OM > u ncoupl cJ p~ c-:; •..,~· HO'.'.?' t •vcr11 i. ri_p . Ot:-", r :l~:.yt1 t ho,' dont. e o~a unccu-cled •1t ::ill. . Ey Aoe--Juror. Q itaw 11'."U\y oiu-u \'loru t1\oru -tiin.t \l~cvupl ud f 1•ur, ·:.he: t r ip? h A 'twel . .. ,I I / �A Q A C\ .I\ ,Tell.• .'1•1rt. 'l.Ccl1..nir.,tod v1.ith .i<Hm 'ipo.i.o ? Ver·. • tVU c..1~· C0.1VO!'f, :l;;;~(;n i -.1.; 1):l;l ye,.11 It ,, . .tll .11;,..1 :•ft(•.r 110 \ ~" -1 ,.:.l~J l . · ,,~cJo ... ' Yo:,• :!lr. rJ~·\t<.: i::r~~ il•1 ·i_t,j_ti y en ::bv:1,. .J.? T \ D tlL 1,0 thu }i,·,::11:'i:V:.l '·:~-1,il h.i.: .• r cuilrntl h.iCl h O'!.' :U i'U.tJtJIClliOd. !Io no.ic1 he c:Pr10 Gi;t cf 1.i~o ~ .ir.n (• r-ly l;ocu xi o Lo .-,r..ntod !.Cl r;ot t.ri ordor fo,:, p J!n r.rd• '. ho :':a;; tw, i.:,t.<,t' ,:Gr.J.na , t.\ t tho ocu:m t.fr•~ he L;t o:)I·.::Jd to th,1 0 ~mt.i.l t.fr~ ,..:·J.1~ p·t~.•,·,1. ,1~n ha r;uw t~o lo.~t cur he. cti, r-t od ~aU:in"' in iµ:1~;1 0 of ·;,.HI i.,r:1c!:. fo tiiour;:.t ho hf>e.r ,J i.hc l.''iO..lOO fre;:. t::o cnrn in i :i.t, ~, :--: -:-.·,,, frc,:.1 t,o.!.inc'l h:lr, tl hr: •;;:-,o It :1~0 Pb,H,, ... : r , . .. ~, 11J c n r a :::huvod hb:: ,~ ,1o~r.:0 bof c,r-u P..11;' cnr \7cnt cvor· h1~ ·:o cl:i.r: no~. Imo,, i:10.1 t:i!\tl;f \iont him 1-10 • • 1 thii.to s , };11!. • r r o 1lcl·y c·\.ld o·?l:t 2 , ru1d trmt it. r;:-.o l •Jt,io.in 1.J mirl 1 !.> r::i.u•,1_~.1;~ b:-,foro tho f.4... 1 t ,-.t n c·!r::o t c h:iF.. ~ill he on') \.'t11) -~h'J f .i,•;•-:, i-:-:n t~10.t ;·o-t. t,v hir: \,:ic ? iio ct i ri u</G oc-.y . 1 't) did m,t i:no., t :.o r:.::-.n . '.i'llio ·.-,no " 11 ,,:: r,t,i .. f,o ~ ,. '" :· l.o· 1., ~-nc ::cc i•J t..111? Yoo • !) !)o f't .~ n ,~ "c.il'\1 ! e;n 4v ·-~ •• " ~- . ~ f r , : , -. , ., · . i : . , .~ : : o a : '(, r . n c c ! t r . u a v o r . l u n ~ e Q !\ ~ a r n o v t , r By 0C:.l'CH.:JO. l••,T!.Jrvr. A y->u kno11 -:inyV, ~·1•~ • .: c1.1~ hl,{ fer ..Uy? '.a.'i m dCJct, 02· i •:i hri !: b if :10 ,;"'.c; o rnr..iJ.y :::.-:.,10 r. n:I :10 r.nyu ;10, 1:ui i1ofortJ 1,hll ~1,, f$t1l· !:o ih1. 1.:tr1~.~c·1 . r hcnrd <.o- .r~'J i '.'2.:'t :w r :.-; r ,·ieu e wi,~ 0.1. f:ho h•\;l 'v ri.~ c'1.ildr-1.n H i".. ~1 ~~l~o 1'.ir~t r.r~n 0 r a lw -:-, olJ :ie lut1i einly a ,1ifo ~.vt 111., c> :-.1,rr:m. i 1· •.1lt~ r o\.·\•:~,.,r. n "l<J l ···, t,Jll ~10•1 •.. :<!r,, 11.!.0 (. r--,.r, ~l'J \": ~c ? f\ r t,h;.nk I,oohrm, r.(•rr ui:· . Q Ylu~t cuur.tr y...:,:: .:nr. h')i I\ f!arniolkn. �{1 if '/ ·•.,,., Th, St•~tQ of ,::roi .in..: ) :•t (' O 1.: u~rt~... C-1 f~ "!-:noi;t,:: • ·~ ,":? ) Q ., •ii, t" -1"• "t"· 'ii .. ' ~ . . __ ;,.... • ii r •• - 1 ;,_, o: u.tt.;l:y o ~)! (10? • nm : .,(H...~::.-.11 nt F'-' v i. ln00 • T • ,,_,,..," , ~t• .,,, h .....i).~ ,rte l•· ;• ,111!1!! ,1p-,.1,u •;.•AJ~' ... z,•J·.l·r l~i· IJ .. ,, • Yo,1 n:tr. ff<l:r 1011r; ~id !,11 ~~l''l; fo1· youg Ai. m.i , ~hr~o i:1:.,ntlm . i)u yo~l Jm.:, ,/ 1:r:yt.h .i.t!'~ .1.n rr~:t: rd -:.o '!;):lo l\ee:idc.1t?' r do· nc r, tno.1 1~n· t1 :t:,r; n»·,: t.1i.l'!'l ..-:!mt :r. ?rnu:Ptl fr-tt'. ot.nr; z-c hccuu!Je r w~ 'i'lw 1::·:..• 1111,,:J r-, 111 ovor by t!lo et~~~!'l :.111~! 1 r:.(;,a0 inquir-loc ne tu ho·.,, :lt lr ) 1.oan1o Isl ii. cll-:tr:...-~:r~ r.or tiw r.::.m ~~o co~..-:] oa~.; vf i;h0 !~i:w on 1, r.in r':of, oir 1·o:id? Yew c.1\-, it i r. "'t.1m c,r ly ·;,rnvnl:ln::; J'v'.1.:1 wn 11~ve. 1 ~ ht.•.i. lo r,;mG?'r, U.y cv:•nlu .r·•~i n. ~mfo roa1 'to co:f('i oqi, vH, :l.'.; it? w;,t ti:ot0 0 Ynr: , t:h) A!l~J ro,::dro:, , ;n hv.°?.G::. <>11.:~ry :'.:M.rty ,:t~rdc . t?o.rn tLon, I• "'}) .!Dlr,,1 :.:,,n•;) , Yoe. :) I\ q A o. A Q I~ \"'hca't) wr..n ho ,.•vr J:j.w·? 26 ri>v11, fJ 0;11.1•:l , :i'p1nn00 i.",1r. ~ r:.-:,.l'i l !t} (:,:01.nf;Y no \:JeO ft. ~_inot'.' \7ho \?rl.1 iw ,,01·1:i::c r,.tt!1? ! (ltmt r' C:::C· .1J~W ·i,; lll i ..m i 0 G m::.10. J:y t'.:.tlr , Juror• no r "-u lmov ',';liut!1m~ ho ;:-m; :::1 <1xi::or.:l.,)ricc~l i:;inc:w or rn;/;, ? I cmui:: rio~, :10y t~~- t,o t:.e.t. (I.. [;O C{! t.:,m 0 Fu \': !lf.' r-oJ.nr, t,I;"0i;'t.y ~-:olJ. tml \7;.W ~c:;£Jirtfjrcd �Tb t t of ,yo ili•• ) :-.... CoPY OF VERDICT Il:T CAO.E Oli' JOHlT SPEC 0 We the jury duly em.:..,anelod c.nd sworn eccording to law by Mike J . Da.nkowaki, Coroner in and for Swe::,etua.ter county, Stete of Wyoming, to inves tigate into the cuuoo of t!-.o Coe.th of ono John S1Jec. After viewing the b ody mid plc.ce of c.ccident end ll'3 a.ring the testimony of ,•,i t nessee , Do fin4: Thnt the so.id cTot..n Spec co.1:1e to his death about 3:10 o'clock P. u., Dec . 23, 1904, c.t the \7yor.iing Gcnero.l Hospital from shock s uperindu ced by injurioa rec4ivcd about 4:30 o I clock P, lf., Dec. 22, 1904 , by b eing run oyer by the rear end of a motor trip ne a r room 26 in no . 9 mine, property of the Union P~~cific Coal Comp any of Rock .SDrinca , Wyoming. Wo further find t h e above to be accident al . ( Signed) Chas . Po Sorensen, .David L: . IIuir Wm. Aaeo Presented to me this 27th d Ecy of .De c ember Ao .o., 19 0 4 in the town of Rock Springs , Wyomi ng. (Signed.) Mike Jo Dankowski Coroner . �.. 9 I l ,.. ~ Bo 9 1' 1ne .Oe c , 2 , ,., ~no. , lS 04 I ,.•:..s coi. in.": o u .., \: i t11 t1·1u 1 I o•o ... • · ~••• " • "t •1 1' on .Oe c ~mbc r ftitl;r 1 r-.2nd c.b ou t 't ,· '• () c. e;lo c:k lJ oln o c.'n <.t thi.: trirJ '· ·n " ncou 1 d d ,. .., '"'' •::; v •.fJ •J u.n th ~ tri 1,1 ri der liq l g~vc '"" th~ o i grrn.J. Lo n t op " o my ;:.t t c ,. t i or. ,,a.0 dr.:,,n i li!:h t a, Lh..:. r\Jf'0 r i:: the s i ;inal O r s t o:•tJdd I d i cJ. no t cic: e thu m-..n comi ne out 0 ..,. t c, ot ran ,,;:,ck to \''hv r e; th t. !· t'.n ut ..hc:n V,i;; l got him out f ' rom ••n dG r t. h..: ci.rs o I thinic t!1..: re h a d t .10 c urs run I ' ot bu.ck t h~ r c •' c.iJ.• S 0 ::1e l '- t .him out f rom ltn (! t-1 • i,\ : J c ue s bv.t cf h i e cc unt.rymen had come .::.l ong D.nd • l!.' Th e r·e ,,..,.,,,; pJ.eni;y u ··•nC, x V VJll • ,.,,ot or r e ad. on t h e· n out 4: 30 :1hore h e •:;:..\ S l yine; f the t r i p• I t war, .... ·n ;),Y o f or ,._i t o u"'et out of l,h ci • _,, anyt h i n ~ v,as t o -.,1ame li. 1.i d t t t h l ! IA I do!1 • it hapvene • 1 0 clock J;:J .T"l e v,hen 1 tor t he accjdent. ( f; ·d) :rosePh ' _!) ,rut ·' �~ PACIFIC COAL CO. ON Mine No. • O'F pERSONAL INJURY. • ~ /t~ 8up'ts No. ................................... 790 Mine No. ; ,, I 1/ Time 7' II Accident r ~p or t or John Sp~ic \'litneaa Statem0n t Trip Ri d e r I vw.e coming out o , r ear en d o f , 0 t or t rip .,h e n 1 ~ c:are orune unc oupl e d fr om tho t r lp b ut i t hei n g down g r ade th•; 1 2 c c.r s f ollC".·1e d the rr• Li n p o.rt of 1:h 0 L. r i p ou t b u t o. spe.o o bct ue:en t½ em afte r the main p a rt of t h t~ t. r i 1i h a d 11as s ~ d. He mus t h o.ve ste!)l>~ cl i nto t he t r-uck t o \• .J.lk out no t thinki n c; tha ~. p .... rt of the t r i p was b ehind ,;7:h : ch purt h ad c o.u • h t 1 :j P1 , k nock d 'L:! 1. J.o;;,n c.. nd dragge d h i m about 100' a h o s t opp <:: d the) c a r s , two c ,:, ra had run ove r his l eg s an d I h :t1rd a rno.n ho llo\7i ne ...nd rl I ,.,lmt a l o ne ·\,h e c a r · f ound h i m l e.y i ng un de r the C c..'. rB o and I coul d not d o unyt h i n G lYJ.Yse l f t o get the man out but I run f or t h ,-; mot or man t o come and h e l p me buL w:1on ·,1;;; g o t b a ck t o h i m, s ome of h i s c oun t rymen had c ome along "'.nd t1:o t h i m out f r om 'J.nd1;? r t he cars s o we put h i:':1 i n an empty car und brought :1 i m ou t.s i cle o f l,h~ r'l ine, I t ,,as a bo ut 23 r oom ·:iho r e he v;..,. s l y ine; on the r'•o t or r oad o Th ere ·;10.a p l enty of ro om for h i i:! to e e t out of Lh a v, u.y o f t h & t r i p o I t i:rar: a ou t 4 : 30 0 ' cl cck ::,J . tl , v,he n i t h a py e n ed. t or t he o.ccident. I do n ' t think anyth i n g v1as t o ')l ame I I �Form 123. } crFIC COAL co. >~ I ,\. SO NAL INJURY. Jf ]'HR ~ ~ 171.PL :Jent, ~~ - r ~ a t e " ' "·· · id/II'' ' 190 Mine No. 1/ Time 7' ~ Name of Mine FormaJ;; ~ Marr·e ? n ~ d.. 7.Ar1:;: -~ Oo ,t,on .. . or Circumstances, g ~ ,u - · eSU/1•t ~ ::/1 injured, .:J 2.... , 01· Singfo /y, if any, n mp/oy, of Oo., nd address of nearest /iuing Relatwe, 0,,,.. O-J efficient man, ~ ,in whose char(i}eft, . w{(he tenype~a~e, ~~ ' {/ p, o. Adress of Witnesses. ~ -~~ ~ I ~ <J- (Signature) Title, ~ ) t-zr, /4 CC{/ r 4~ ~ hgsician called, if any, f ,nent of Acoident, of life ~ l ¥,_} ~ ~ ~ olo-•"vl 6 o(__ i �STATEMEN'fS OF WITNESSE 8 • 1 Rock Springs, \/yo . December 26, I was ru.nning a rn ~ning mechine today in l~o 8 Mine, .36 room, 4. entry, 3 Plane. I hcd cut seven ,cuts in the room on Saturday Decer.iber 24th , tl..en \"lent in thio morning pd started to cut . 'l'lhi:i.c t he mo.chine wa s runnjng I got down on my hands and knees o.nd looked uhclor the mining t o ooe if there were any stamps left . \'lhile doing so I l·oo.ard tho c oal commonoo to work and tried to jump out of t he \·10,y. The coo. caught me however and bruised my left l eg and my back. Had s ounded tho ooul bofore sturtine to cut and it appeared sol i d . (Signed) V Sherol. 1904 ' �1ufi _ 196},1 li'orm 1:?:J. ~ p ACTFIC COAL CO. tH-110~ --- Mine No........................................ oF pJSRSONAL INJURY. Jllirof?T 8up'ts No. ................................... 11,1nre of_ , upat1011, oci , o' Accidellt, o,.t, 'J ~ ~ r ~ cl)_ ~ ~ v"~ . 790 ~ Time o,J d Mme No ~er' Entry No. ¥ . ~ ( ---..: v,cation, . state whe e i11iured 111 ~ mr, , ,1,,0t ~ f f/tlfl1e O A f,fi11eSupt. • , , ~ , ~NameofMineForma11 d:2¥ • • ~ .1 Persoll _1111ui ed, AgC OJ I ~e 7/~o.. 7 " . ~ crsoll i11jured, P \ I c:#_ ~ ' ' Room No. Jt - .J ~~ £ ~ r "~ ?J ' ~ '-~ \._/.,A_ Marned or Single ' What family, if any, ,;?/ ; ng i11 employ, 01 Oo., ;.- ~ Condition of Life or Circumstances Holll lo d address of nearesti'· ,--:ii~ ~ wmg Rf ea ue, ~~ ~ , • -M t, was he an efficient man, Was he temperate, / ~~ _g, • ~ ,_fl_ dJY 1 Where and ill whose charge. left, , Name of Physician oaf/eel, if any, I .~ 1-f~ • , Name and p, o. Adress of Witnesses. C/P. /::;:?~ '-7 c:::.,/ lr-P--,p..,,~:.--<,..,o:t..-C:'.__J a:>~ {!Y£e___,~ ~~ ._/fZ,,~ eft • ' Nalure and ,xtent of Accident, -;:?'~ ~ ~ ~~~ ared ,' -----.f ~y---4' /~~~ r ,, ;,t,AIV I ~ -~ e..~ I- Ji~ I ~ ~ I ~ ✓14 { • (Signature) �STATEMENTS OF WITNESSES. I was worki ng on a mining ma.chine, yostcrda.y , Jc.nuary 9'fh. ,in . No a t!ine , ob out 5 o'clock p. u. TTae on 4 entry on Zrd Pl ane and want ed t o move tho !!laohine to tl1e 4th plane . While doing so 1 t jumped the trook . I took o. b~r c..nd tried slipped o.nd otruclt my log knocking Tho b to l i f t it on again. me down. I foll on tho rail mid broko my l eft leg . Si6J1Cd Poto Soche:-..--1 . �" 00 D'. t II' I/ Rook Spr:lngo, i\Tyo. ,jonu ry 10th., 1905. ,~ tj I was working with my brother, Pete Seoherl, on a mining l!:a h I poi i n lfo 8 !ilne ·yesterday. \"/c ,·:ere moving tho entl'7, whu it got ott the track. l ift it on again . rnaching from 4 t o C 1tt ) tat 11]1 5 I rihi Pete took o bar and tried t o Ill He elipped and :!'ell on the ro.11 and hurt hi s leg Joseph Seohorl . lati , t I I l I~ "lt.. �lt'orm 11!:l. ~roN PACIFIC COAL co. 'fill\ VN _ . 1 __ Mine No. ... ......... ....................... V .1,I T OF PERSONAL INJURY. pfWOR Sup'ts No. ................................. . ~ (Ja/llC OJ outc OJ ( \ ' ,;e of person !njured, \ 4~I to 9 ~ . ~ 190 S- Time Mine No. J> r.,....-4 ~ ·~ J N me of !,fine Supt. ~ / / I/~ L11cation, 11 . . din Minr, state w1,ere, f' 11ot /ll]IIYC , (· \I f~~ .1 Perso11 injured, oco11Pntio11, . .1 Accident, i d' • . ~ Entry No.S - '' /(7:,.a,..,._ Room No. . ,... . ~~~ Name of Mine Forman, • J~ - J--.. Jfa.~ , 0 ;,;1-t:_~ ,~ .. ~ "7]17 • ~ ¼\. Name and p, o. Adress of Witnesses. 71 (? Was he tempera&, . V. _n ~-.,c_ g D-f _-R. I ~ ....~........_~ ~_ r ~ Married or Single , What family, if any, , '/ HoUJ tong in employ, of Oo.' .::( ' ~ ,·· Oonditio~ of Life or Oir:cumstances, Nme and address of nearest ltumg liJatiue, • ~ _~""-"<- ~~ :as he an efficle11t man, . u~ and in whose cha, ge left, 1,,,ere . _ Name of Physicfa11 called, 1/ any, I' (7 ,.£-<.. - --..._ ;:;~ £~ SJ ' -,, / ~~ I . 'I j I (Signature) �STATEMENTS OF '\VITNESSES. Rock Springs , f!yo. J anua:1:-y 10th . ,,1905. Janu.er;v 6Th/ , 1905, o:'c 3. 00 P .IJ. room. I otartod to nm a our do~ the one oprag broke and the cw... went very fo.ot • ·leg got under it ond got hurt. it j umped tl • 1e track a -~a my ri~th ..., (Signed) TO To.Shiro . Rock Springs , '.'i80 . January 6th. ,1905 . I wu timbering in room 24 , in (3 Dip Olltry to n,y.. ~- Tashiro was diggi ng coal i n t hat room on<l about 3 . 00 P . H. ho was running a car down the r oom. One aprag broke o:nd tho car uont very fast Taahi ro hold on to the car. so f e l l on his ler; . It jumped tho trc(}k end in doing (Sgd) So tiade . 1.Vitnoss. �1 .C l Form 123. N pACJFIC COAL CO. tT~rO• rJJI\ • I Mine No. ...................................... ~ - pr,'RSONAL INJURY• . ,oRT oF Bup'ts No. .. . .... ......... ............ Ni:l -z.~ r:,,mcol \ o,11~ fJJ ~~- I J. , ..z~ pc,son i,ifured, t lt·. Occ11Potion,. ., Arc1dct1 , , ~ )) ~ !~~ , ? ~ • 790 S Time Mme No. f' -------------- Location, d . t,1i111 state tuh re, . ·ure Ill , , 1f 11ot inJ ;:;: Room No. Mit1C supt. .......z ~ ~ ~-4(__-Name of Mine Form~n, ..- ~ ~ ( 2 0 pam~/Person ;11jured, ~ C 1 ........._. Mamed or Single • .,. ,. Ago 01 . ~ ....... hat family, if any, .. . 3 th IV . employ, of Oo., Oond,t,on of Life or Circumstances '---\ Hw/011gm -:,/ , o d ddress of nearest living 'Relative, )~---a--r~ ~ ~ ,,di,, • tame all a ~ zr ;.. . - -/ ,/ 1//"'-~--~. an ojfioient man, ~ Was he temperate, ~__, 0 • • h fjase ~, c2 alld in whose charge left, ,,,.,,_ c.-.• X~~ _l?_ ~ - - 4 ~ .3:::c:,.f) Where . ~ ,;;; ---/-- - ,1 Physician oalled, if any, { ....,,_~ Iii..!. 7 --~ ~ v~7 Name o, Nameand P• O• A • 7 --...... •l Adress of Witnesses. I t I I, ft' T~ ,..... ,. I !ll l I I (Signature) �STATEMENTS OF WITNESSES. \ .' �STATEMENTS OF WITNESSES. ;..'.) I I . - I T ,f,l i \. •1 · 1 ( A ' . <J ~-l · (',{ , , ·•,2,;· ' ' . I , t r/ ; 1 .,,, 1· I 1 /i ', . t 1 r,..'77,;,.· ,I ·' ,J ., • I •l / / / ./ '' / / / ) 7 ' .,{/ • , ,' .4 - ii :o· ~--'i..., , ('~.: 1 ,. e,t i()J , /1 ,r J ;·:•,' # . " r, I ✓ .., , ,,' .,_ ., , ·y,, I ". ,' J t I . I , , . ti . I.,/ ItI • ( , .... . ' .' 114$ 1/.,, /}I~ / .I,. 1 / Ii . : ,( ' t i' , 4 / ::} ., 1' r'- .,0 1f ~ / , f.Jt �1116 ~ p ACTFIC COAL CO. tTNI01 199J .-, OF pRRSONAL INJURY. Mine No. ........................................~ i p/:'/'0R1 8up'ts No. ...... ............................ ~ U pc,sDII i11j11red, ,{__ f!lllleo1 ~ {J / ?--' ~ 11µatiOII, o,c if Accident, ~ oat?~ ,,,.,,-.,, Lo,·a/roll, .. red in f.7ine, st at e wI,are, /Jmll tnJII - I 79 0 n5"'- Time / ~ . 3..-o O'bt.. Mine No. Entry No. _,,. ' -<-, 1 a-Room No. v r.,::, -r~ ,--;P,J_,,,. ~ - __, - _____ , vo Name of A.fine Forma. 1, y:- 1 (. € ~ --;-· uamo OJ , • • d .:::>- <L •~ ~ v ~ • Age of Person ~n1ure ' __ ..-.....---...(/__ . Marned 01C.Single _ ..L • hat family, if any, ~ IV 'ong in employ, of Oo.' / Oo17dition of Life or Circumstances Hoio' t 1· • I t· _L ' , d address of neares 1u111g e a we, 8'-~ - - ~ Name an l-, - - - - -~ was he an efficient man, Was he temperate, in whose charge left, ...o---v -?'/ • and Where . , , , ~~ ., Physician called, if any, --<}. c Hame OJ ., (,fine Supt. 1 4 ?e:i~ h'- J? K. /lame and P• O• Adress of Witnesses. 1/ature and extent of Accident, !y< ·, (Signature) 1fo~ ·, I ~ �--------- STATEMENTS OF ,vrTNESSES. 1/ature and ext• ~ �Fol'llll!!:t. 8up'ts No................................... . • ·11red, .I pc,sOII Ill} N11mr o1 ;Y. ~ - . ·,., - ~ /'1 ---e__(J (;J /,) ,. V , ~ ~ o·•U/ltltioll, •• ., Accident, ,,,/ ~ ~ /-a:;,' {}ill' (... __,_, 111 -, ~ 0 Locati _"'. red in l,finr, state where, 11notllUU ' .1 JJinc S11pt • uameOJ • d' { person in)ltre , \ ~ Mme No. ~ , I, P.1 ~ ,.# ~ ~,,t / ~ ~ d' Age o ·1 if any, ~ ~ What ram, y, ~ ·n employ, of Co.• I/ ?t-<--c>->~~ Howfongl ,. . RI t" .., ddress of nearest tutng e a tue, ~ -~a . asheanefficie11t man, ~ _ , 111 , din whose charge left, ~ " Where an . uams of Physician called, if any, 'it L! l flame and P• O• . o(j"-'V' o-l- Entry No. rD .,,,~, v~-. . - • _-:;.'L_ _ . A -- -~ , v ~ A Name of Mine Forman, M . nd Room No. ' - - - . Q.,,., ~ ~.~ ,.7 _;;1., ~ amed or Single ~ .. Oo itton of Life or Ciroumstanaes ,...___ _ aU-o ""'> .fv/2,,(A-" G~ .. _ /_ ,, n I ~ ~--~ =~~~ Was 'he temperate, L&<T - r -:;-u~P ~~ ~ .:""v I .., , .,_e, c::,-< I r -t 0- ~ ,~,. Adress of v,ttnesses. Nature and extent of Accident, 0--<-<-J. A . 790 .lo Time ~ o ~ ~ w" I -- --.. J I' (Signature) 1 yo J' Title, ~ } ~ / �STATEMENTS 0 F WITNESSES. ACCIJlll.'T REPORT to THI UllIOlrPACIJPIC COAL COMPAl~ • I r.M T Nakata wu working in the mine o-r eight as d&«Y man on tl1e I eJ1 13th of .Tlll'I 1905; he wu employ111g near the cqe •~ this mine to wort I (,0 fb ,, in tor pushing the coal care into the curtain place and injured by aome . coming h1114 OU'W to pressing him between the cars and finalq relllOved u~ into the general ho9pitaJ.. nt nd Interpreter, (Signed) .. T•· A1kaw. I p �Fonn 1!!3. N' pACIFIC COAL CO. O t1.NI rrt6 _ - - 201 iJ' Mine No. OF pRRSONAL INJURY. Jib•f'ORT 8up'ts No. p rson injured, t1,i111c of c (ltioll, oc,1111 'dent •• ,I ACCI OC.1' ~J L.,,,111011, • ••••••• ••••••••••••••••••·•••·• wL--..i 7 , 3 p,(;- 790t,- -:j Mine No. /~i,Jc.,,,-lfl./ "" . . I/ ,rot 1,IJLfrot1 . u~0, l)J/. ~{,(/4,(J,/V',,. 2w . ~ ~I ' .. ill Mm,•, st at e wI1ere, r Time • cf. ~ - 13. 1 t,1i11e Supt. ::,J,,(A; • Name of Mine Forman, ~ . 0 Name~ •• ,(I ! ? ( , ~ .1 Persall 111) ure , .,; Married or Single Age o, ;-1 y ~--::..---, What family, ,, an , (IT/ J . .. /11 employ, of (Jo.' ;;..ft/4l,f./ fJo nd1t I on of Life or Circumstances HoUJ long . . o / t· CJ_ , I' , address of nearest 1Iu111g ne a iue, a,1/4-V /U4--it ~ -r.J p /_,,,,/ , __ d Namean .._, ,.. (I ,,,__ ,__ ; 1 ~ ~~ Was he an efficient man, J.,.L~~ , ' Was he temperate, ~ f • d in whose charge left, ~ ~ _,pf?__ L '-y-4 Where a/I . ..,/? t_ ~ -v v ~ ,1 Physician called, if any, 1r,,. ~ ~ Name o, • • • • r1' ~ /lame and P• O• p?, Adress 0-1 Witnesses. 'J ...r' .. '. (Signature) Tf(}J: //~-13.~ Title, ~ ~ /i �STATEMENTS OF WITNESSES. ftM'D.DT PF iI:tiJlJRB.O P.ARTY • The Union Pacifio Ooal Companyo l :was w0r1ting in the mine of Hine as a. miner and when m •as lqing ao1m Ior vicR1ng coal ~ome coal fell on me and 1njarH ( Sj ned) v . Ot a . V.'i tnesa: (Agent and Interpt·etf)r, ( Signed) Nii T. !Ail::awn~ Ct �l!1orm 123. oN p ACIFIC COAL CO. ,rfJS oNI ___ _ _ _ Mine No. , OF pJSI?SONAL INJURY. 1 ~ roN 6 ou••• •• •• • • •••• ••••••• • • •••••u••• ••• 8up'ts No ..................................... }t, k ,1 Person injured, (J11t111J OJ (})~ t' /) //1, .....-.'1 (JfCil/J(I /O • (} ~ /,1 ~ .£ oate 01 Aau•1 de11t, ~ Mine No. L0co.tiOII, . .111·ed in Mini', state wh re, I/ 11ot 11U r Supt.; ~3 {)J.A-1.,fy f{ame OJ.1 t,1i11e ' ,_, • - v ",t'}........j,-.--,,4 if person injur d, I n-;,. T i m e ~ & tr-la,~£. Cl, 9' Entry No. 4:' 1 Room No. -2.f 7900- c ~ -- Name of Mine Forman Married or Single I :::a; family, if any, ..l ' , ,.., _,.-1.. H Jong i11 employ, of Co., ~ ~ Cond1t1on of Life or Ciroumstanoes otU d address of nearest liuing Relative, ~ ~ - ~ __.,, ' Namean was he an efficient man, nd ill whose oharge left, Where a . ,\ Name of Physicia11 called, if any, ~ .,7 •- -r-~Was he temperate, _ ',j,,U2-- --f' ~L- , ~ ~' )~ / ~_,,,f /.J fl o,j - ~ - -f ~ ~ ~ . jld , ~d.,, Name and p, o. Adress of Witnesses. /Signature) If tl~--_ r, ~' ~ ~ Title, • �STATEMENTS 01'' W 1 .u"n.:,uA-1..., , \ . �I ,,, 7 /@ ~ f . .... 'f . ....... //ature a {,µ I ,_. I , . I • / . .. \. ,. 1:,1·.. I/ '..r., .,,_ ,, u Cause, �F orm 12,1. N p ACIFIC COAL CO. (TI-HOi 'fH~ __ --- Mine No. .................... . ) OF pBRSONAL INJURY. p/l'f'Ol\ T ,f person injured, N£1//le 01. 8up'ts No.................................../ J,t,aji -(P~~- »~ ~ . . . .. 3 g;_, of fiectrfent, 1 l- -✓-1 1 , ~ I ~ occll/J{ltlOII, . 1/' 1906 Time ((~ ! JO Mine No. 117 E~~y No. /'I L----- t 1 ✓1 oau /../~ d • tiol1, 1v;-c/.v , 11 Loe . . ·ed in Mine, state whe ·e, If not ,,uu1 (7. JJ;, Room No. _ _ _ __ fB ~ - Name of Mine Forman ' ,-' ~ . ot..... 1 ~ ., t,fine Supt. (/,,J / : (lame o1 , , Married 6-r Single ?J,~ ' ,f Person injured, .;). '/ :I~ Ageo1 . v1' W/1£1t family, if any, ~ Hotll tong in employ, of Oo., lv~ I ~ r ~Oondition of Life or 0ircumstances, d address of nearest living Relatwe, ~ a fl /J --4/ l I name an ...., , V ~ - u u, r ~ ,f{; • t "./ Vias he an e»,oien man, ,, .,,(.-,,1/ ' Was he t mper le, I .v.· , ft:r 1/, I/ Where and in whose charg~ left, r-z,,,,~~t,<4> Name of Physician called, if anyJ ~ ~ /c.L._ ../ 'r / _ ~ , ~- ~.,__,, Name and P. o. Adress of Witnesses. ~ ~ / JJ, ) .,£ UaAd~~. :1 (I I t ' Nature and extent of Accident, LJ 1-·~1~ a!./J · · ·,<4<k -;r , Uvf ~ I i) 1/ I (Signature) l(/OJ- 1~ Title, cf'__,, ~ ~ F~ /J I 11 / �STATEl\lHN'l'S OF \VITNESSES. , �2·0-1. ij1 Fonn 12:l. Mine No........................................ L-- I 8up'ts No................................... ✓ ~ . · • ,-ed person u1jlt , Z ~, ~,.", r:on1"of ~A./ t dr,~¥ ' ·Arc11e11, 1 . ()L,1,pt1liOfl,_ ~v , 011/t' nf -~,, ( ~ ~ ~ 190 Mine No. ~ L,.cJti~"• d . t,Unc. state wher , , •,;,,re m ' 1 J~,~ _. ) • ~ ' - ; 1~.:t..-, I' Time !"• H n .,/1'- ,.Pt-<, / t:J Entry No. ..3 Room No. o i If not ,n, i.. , ...,._.. " I f. ~ v p ,,:;1, ~ - of t:ine Supt. 1._.L,Q • Name of Mine Forman, 6 panie., person Ill} • ·ured, ...3 Married d;,1g~ile • ~----, AgtOJ • ' ~ mily, if any, 1 U'ha a . employ, of Co., ~ Condition of Life or Circumstances Hw/ongm •• RI. ~ ' , 0 ddress of nearest llumg e atwe, ~ Name and a ~ ~ an efficient man, • Was he temperate, ~ lvos he ,.~ 4 din whose aharge eJ t, ,_ ~ A~· Where an . ., Physician called, if any, iame 01 n-~~ 7 o Adress of Witnesses. 1ameand P• • #olllre and extent of Accident, ·~,~. (Signature) Ii I I �S!Am«Bff OP JJ.S • !ASSO Book Springe , Wyo. October 27 n .19°' I a driver employed in No o l lli.ne at Rock 8Pl1bfe I, Ju . !aHO, am tor U.P.C-.1 co. Oil the 26th day ot Octobel:- 1 0 t I driy1~ 1, _._..,u.. f•om tt Hau , .ho . o hu?t i •• 0 Oltl 61 •trJ ,1 NII ... •. a-.a.'9";&.-., "" in eaicl entr7 an4 min• on said date. I g ve hi o. car a.bout ·10:20 A. M. that was the second that I had pulled up his room tllo.t day, About 12 o 'oloclc, I went to tJe _foot of bis •room and took a lolde4 awa;y f rom there ._ I did not oee him or hear him, I never atoppe4 to liaten . .lbout 2: 16 p .u. I took an empty car into his place IZlt PQlle( 1t up to n••~ the face and I could not eee any light at the 'face , 10 I hollered to him and I ho rd him groan. I went to seewhere ht 111 and foal hi■ l&71ng pretty nearly covered ~ith cool and bone oo~ . I pullet a few amall pieces oft of ijim and there uao a large ohat on hill that I ooul4 not move eo I went to e:a _. oom c.n.cl got two 111 to hel p • get him out from under the chunk. Thoy got him out anl took him out . to the elope in a co.r. We thought ho uas pretty ba41J hurt and I went ~1th him all the way to the t'yorninB General RoapUal He was working alone. Hio portner r. _a not in tha:'t: dcy. (Signed) Jas o ~ Q SDOo I I I j Ji~ I f: I' �.... "• ,, ·"'' U· tP ,1.1t v· ,t~ if' ..,.·! r: ,,.~ ... ~ ,~ (;l I f.l! I ,, j• I, Jlalt 11&11:ta, wae oot. on t he 16'1l I~ of - I TT HAUTA • S!A!EllD' T I ork1 in "ne Iro.l 190A. Shortly after 11 A .Tl. , I fired a ,. room 51, on 41 ent?J ahot am ba4 piokel down the loose coal from the chot uhen I t urned aroa:DI top ant get a prop to put up when eorno so~e ooal and bone fell Iowa Jmookiq • down md pinning o o I could not move . I wu 1B t hia poaition until the driver noti"cod ~:l, about three o'clock I i n the atteraoon. (Signed) Rook Springe , Jan. 26th. , 1905. Ea.tt:l Haute. �Form 123. 205 , Mine No. •••••••••............................... I L- Sup'ts No................................ .. k '◄ . . .d / ?C:.-~ ,~ ' o' Pt1rso11 111)111 a , (,',1fliC ~ /£/~ LJc_;;&, 6<.6'"' ,, o~taof Acciden •~.,.._,IT"'./QJ~.;r0 t ()··CIJPlltioll,_ •oe:ition, • ,,h ,.;;,;;;;t; wl~re, ,etf . • •11 1/11ot1nJ ~ Ill ' ' A 6 790 ¥ Mine No. Time I ~ Y' ~ // ~ 4.~ ¥ 1 Entry No. Room No. z~rr 0\: {/~ Name of Mine Forman, ,:<} , Sr, o E : - : : , J 0 ; jured, ~ Married or Single ~ 11 11 Age of per~o r1 any ,~ U , t family, '1 ' .::i .. . Wha . employ, of Co., ~~ Cond1t1on of Life or Circumstances, 11010/ongm 1· • 'RI t· )A, n ..... , - . -,/ --:-' "' ddress of nearest ,um ea we, -~ ,...~ . 7 ~ ~ ~ # me and a , ~----w , a elnoie11t man, '°Was he temperate~!).,./ fJ was he an »' q ,,; , ,-c,, , dill whose charge left, ,,,,,.- . ~ ✓--<~~~ Where an . J1'. ,C') rZ> ,1 Physician called, if any, ~. vr. .:;:::t,, . IJ( ---e_.fl, //ame o, , tame . Supt 1Af//JC . • O hi. Namean ' d p O Adresso/Witnesses. • • c::;7-~ ~ ~~.H (j O ' .Ji_,~ cJ- Nature and extent of Accident, d1v" ~ ~ - II I (Signature) Title, �f ,_ ' \ •. \ \ I ,,• • .,_...,. ~ ...., • ~ c:.•' ... ,.: ...._ I �\ ,.I . ,,,J j ... . l V.,; - ,, ,I. • , I.!,,., ' , 1,, l/'·tL,.d \ :.. , ) .,.'\. ' \, ~ . Y. v tr))-_ 1 91 ti- · I ,---., (l .. t/ • 1.. .,. - -t: • • I .r • �Form 123. crFIC COAL co. O~ PA • lJ~I I ~ - - -· r1th soNAL INJURY. .,,oJ?f 81l oFpER ,;pcrs011 8up'ts No .................... ............... injured, '"Jz,,-~~ • /V~ :1.1mo <>, potiOII, G••U ., Accident, /2? i '-' ),, ,, o,it.i o1 J/- ).lo-v-; .!/1:Z 790 Mine No. r./.24~ (fi:,iH:,I- -r (J • A~c~ .S-- Time I Entry No. L~catio11,_ . Mint, state where, ·0111red ,,, ,1aot1 ~ JC/ , (.line Supt. . •ured panic 0, ' ige of person //IJ ' r ·ty if any, .. , L/. / :z: <.__,,,-/Vnme of Mine Forman 7-1~ -/ • dl ~ /' , -r.s--- Room No. / c; ✓ ~~ , Married or Single J ' ' Whal fami ' y F co., I c f ' ~ Oo11dition of Life or Oircumstances ------ - in emp1o, 0'I . ~ --,,4' , , , .... • Hotll fong dress of nearest living Relat,ue, . ///---<-IZ~ ~ ~ 6 - - - e . 4 ~ 1 , me and ad ~ 7 - •f , O 1 "-, ~a , ,11icientman, ~ ~Washetamp~rate, 1"as he an e»• , , ,. ~ t. , din whose charge left, . ,1 PhYsician called, if any, ' Where an _p,-. /'_..c::> " ~ '\ -..<?-P--f , • /.,. 11ameo, Kameand P• O• Adress of Witnesses. Nature and extent of Accident, ~ •• • I •' ,.___ I II I (Signature) 6-te I •..,. ·~·tu. ~ ~~ �STATEMENTS OF \VITNESSES. �20 ~ o! C COAL CO. pA. Ci 1.·rO~ v:-. 1116 • . , rtr F~I 0 Mine No. -- •••••••• ···-········••-. .............. - -: ~oNAL INJURY. oFpbR II • ' .. red, .I PJ/'S011111)1 ' 1,•.1meo1 11tiOII, 1 J//~u_- QiaJ/ ~,~ ~ (I ~ a,,11/, I t1.~:'P., ACeiJc11t, -z:t:' / 1/ -:; • ,/LAA;,~ I r 11ic, J f,,.. . ..,,tl/f'' - t ! L,catio11, I . l,fi/11', state where, .. ,red111 '--7 I /j f,,)I //~/ / ../J/1 f' /.1 C\ ,, 7~ { {,fine supt• ~ • / r. ~3mc op injured, 0 5011 J eof ' • 190 ;J ' Mine No. 7 Time t24-~q of Y~ Entry No fl • 13 . fl I) 1 ~ , ~IA./ r::::f..... 1I • I).,. • - P-/Je.p,;.e4 ° /Single ~ •~she an ejficient man, ./~ • , #. Was he temperate, I, din whose charge left, ~ ~ ,u.A.--1- v{ ~ ' J - : . t1 ~·nerean . • (/-1r_ /.,;_rt_ /I) /'J .J. ~ a..,{ ,; Physician called, if any, I l.-, 1<1- ~..../ v e t .,_, ,( C?A.!.vt- J rame OJ Nameand P• O• 3 Name of Mine Forma,1 . -----g Fi milU, if any, ~ /J - 1- / n () r/tal : in employ, .o f Oo., ~ ~i---i..e..r~ ~ 0ndWo~ 01 Life or Oircumstances, ffJ16/oa;d address of nearest /iumg Relatrue, ~~ ~ - / ~ 3 {) 3 V r,me ' Room No. ' a') fl ~ ~ ~ -, , • Adress of Witnesses. • f, tureand extent of Accident, ! ~ - { { _ , ~~L ,;v&-vv- du ~ - 1~ g2d( I V. / • • l \ �STATEMENTS OF WITNESSES. .... 1;a , ..,,,, ! ..... ' I �Mine No. 208 ••••••••••••••• •••••••················· 8up'ts No................................... ..,I ;.J. -d~ p rson injured, f/J,«,4A-. p,1meof c vJI/~ o,cupotioll, . ; ,~vU , -;;i.. 0 ., Acc1de11t, f 1~ O;il~ (11 n ·-vlv ;..--~ · 11 /V, LoC1111~ '. d •11 Miur, state where, If not uuure , ,,., of u;11, Supt. d • • 1 190 6- Time a~~ /t} C/. ~Mine No. / Entry No. 7";7 Room No. 1.1 ~~ Name of Mine Fo,·man,, /SJ. )::/,,-{)~ JgcoJPerso111111ure ' ~ ~IJ111i!l Q, Stngle rJhai family, if any, ~ .. I0ng in employ, of Oo., '(/-t,,v1::1 ~ ~ 0ondit,on of Life or 0ireumstances Holl/ d address of nearest living Relative, ~ :);£,~ --//;.I , ( /"'i' tamean ~ , l'.JA. ~~ r-, vf-~ washea11efftcie11 tman, Where and in whose charg~ left, Name Oif Physician called, if any, , ~ (I -xiJ/1,, . / l,- _ ~ a . . - t . . ~ {)_,, Washetelf,perate, ,¾_ '~t--v"--t. /Vt., j . , ( . . t : ~ ~ 0/1;, • / v. (Jh ,· \ . r"/l tame and p, o. Adress of Witnesses. (Signature) 14 tJ j - ~ c.-lCJ 17 �Forin l:?:J. e Mine No. e ••••••••••······ 8up'ts No ........... R',, /l • IJ·ured, /~c-;..,,z ,-,t./ ~ 'ri. t<- <l. · <--- 111 (' ,. ,: ., fi•rsn11 "11111' OJ t•~ a ,r '- "'I,;' I . I ·f . ,· j, 1- I.I ,;at i1if11re Ill ,1 , 790:; Mine l✓o. 7 Time • ofl,1i11eS11pt. '). /Jame ~ ••• 1 if Person 111JU1ec. • Age o •• ••••·•·•····· ······· U: t - , O~'-u1•a.. , : t1 : :.u et-.1. ~ ;a~£ 7 ;-; ., A~~;Jent, ,. , ,. I, .:~ ,:i- t•. -, -....~ , , O,,·tC (JJ. ~ ft., j r':!I r..... ·•·rn, t . I .,, v:. •· d • Cini sta e w 1eh, 1 ~II ···- .......... ... ~ 11'j /1 .c 'i ,;&,'l , t"- f t -- {Jame of fi?i11e Forman ~ ,d,_ ,...__/. ,Ii <Or v1,,v ~ ltf0; ~ 8i11gle $L ?-- ·t ;1 any, - - - - - - - -- ~✓-~ u -- ...... rat Fam, y, I /; ~ d - __/ -<-/~ ,~ tong in employ, of (Jo.' rA,?--.rr / j c5:;....~ - # Condition of Life or Circumstances Hoiu d ddress of nearest liuing Relatiue, ~vfatft,,-r,<, ~ d r ..tt:cvL_ _ /J, / _ _ 1. . tame an a ~ /I • ' ~ - n,.,;r ~~ r,•asheanefficientman, ~ ~ Was he temperate, ¾,.c__ ;11 tuhose charge left, _ ~ 1 , - z , , , v ~ .! I ,, ,. , t· 1 J / (].., t', - / - # and thf(B (l..,(0A , • / • • -r"I,! ~--C.. , ' .1p11ysioian called, if any, /\V./v, /c". J1-,~ 1 : r '/ /f'c, /? . / ~ame O; r ...<...-: ~ r . J . c • ?",,__.__ _ l r O Adress of Witnesses. Name and P• • { 2 ~ /:. (7't:J/4 (Signature) I 79"t1 .j - Title, 7//~ ~ ~ I �•• V .a. • ll Cwrberl and, ~·yo . Jan. P.{ th , O• :-':, ~ ;f• ', . r·, ,l 11 s 1.ecdhl-lr- , <;up t. f:.v c.tattm'5nt concerning the deabh of I -a~. lhon;o.~ F l h 1.. l f• e t ny l b c:r· on . "a.rd ..~ ., d"te a. . I c \i, r•hilf-: Ir. Jc>hn L.,_ • s urcr,r,ing ten e:ir.pt.y bo>~co off the. high line:, and there Ito•r, i ,. 11ert .. t,o;(f~r; :~tanding on t.hc blcck, and t..as. Thorric.t> had just ,. fd11n Jo rt the c;ar rq,a i re r "'ncl cr·o ns<'d the s l:,c- k track right 1n fl'ont r.f ,,. i Ad e tlf'~'< r:tt cJ 1·tdc!i1 ~:u:.; st .. r.d lnp; , h e wen t aud putti ng one hand ' 011 , ·,wn Ct.I' oml gJ vl na " qt1 I ck Dprln,o jus~ e t the time the mo~1n 8 cnr:;; hi t , l:nocki n,:; hir" t'rm.,. his holdn end under tl1c t~•heeJ. I 1 r tar t r-, ~s· guic1< a« a fl a~, nn<l conw,enc<d to bloc I< tho Cal's, an; t hen I ,;oer. up tr tho, '"".i.v and hola:1 the head orr t.hp t 1 e:, unt1 J tl:o cnr ~ stopped. Tho arc1 cl o nt occured nbou t 3 : 15 or pc s a j bly a 11 t tle li:t,·r , and about PO rt. o.hovc dul!'1,; nt'tei· one car flhe A 1 ~~nt over the hodv, ho ~us drug f1fty-t ~ feet. ( oi~ned) l'·ri t ten by 11. n . Harrj ,.; . n.ir r Orfj W1 I ft •1r.i 't 9,l~ C O P Y. • 91H Woe 3~ I :1 v:yo. J an. 29 ' 05 • : '.ni1o1 b Cu1rt,or ,.!. ,..rd ..... , ' Regarain½ the acci dent t o Thos . Palroer on t h e "'4th' ' • i nst . , inf orrrat ton as -T ~ a"'~ not near t he " ,~i uns.b l """ t "; ., ve yo u fJ.n y the tirre . When I was infor med of t be r.1 Wt~ o~ the nccic.en~ at boy unde r the car• 1 n.rri .• • • tc the pl ac e and seen the c c-cia.~r.t 1 r a n d0wn f n.im several t i me::; to 1{cep av-e.y , the c a rs rot', l told t hurt . 1 \\ cul d be l 1a b l e to g e , any pl ace v:here he ur.d a.\':o y frct1 boy• .-as also t.cld by t he ?.. inc Sup ' t. nevernl t rre s to k enp t h e " e.wa.1 fr"!T' '-' • the ca.rs. A. E. Palrre r , Out side Fore~a n • •,. ,· ----~~------- \. ' '\ ) �LJ y C O ~ · ('-, t ~ 1--..~-.. '1 -........1 . ~ tl 11 • . . , • -- tP,0• Adress G md extent of Ataic C P C ,... Y �Form 1ZI. TJO~ PACIFIC COAL co. 6 v ;-; OF pHNSON✓1L I NJURY. •roRT i'() I J~~ Mine No. ....................................... 8up'ts No .................................... , • •. ,f person injured, r/f?:.. ~7,.. ; ,u;/ ( rc..,l.t,,,u:., c ,, ·t-~1O /' / 1tion, ( ~tµrtn. (A,,- _. ~ ,;p~f Accident, /,,( ' r,.,,M' l't.;?-f --: 190 j - Time .f/1 n.-,, 11 4' c '-J P . //1 , t . • ,J ~ (· ;,,,-.,;-1-;- Mine No. • Entry No. Room No. ,t;on, ' . / {I . , ' . . ·ured in Af111e, state where, CVJ- ..,~ / I /J _,/_ . - , • ,ot ,n} / {,. l'I..K-<~ w<. ('1 .,,.- f r, Ot tz/.-- J." ~ f • ' \ .. of Mine Supt. ( } t:r 1•/,l,f,,// d",,,u./ Name of Mine Forman, 1.--1. // C_ Q I /lJ £ , " q;,e . . d U> • r<L,,,,a.w '-4.-<.,hl.. '-ttu ✓ rn..u, ,of Person m1ure , I Ma; ticci o. Single 11h • Ll' t cami/lJ, if any, -A. -• fl __.I.. • ;f,, /ong in employ, of Oo. • -:_v~ ~'C4t,.,,-, Oond1t1on of life or Circumstances, ·tlo , a~ t '_,andaddr~ss of nearestlru';}. Relative, ~ ~ a,. ~a,,u.,..,;{j, tl-r--ud<,4ut, _y,,✓ 'll'a~ \..,/lean efftcient man' :z..t_ .t.--' wa/1,,e temperate, tit~ • h6(1 J and in whose charge left, l' 1ght ~!=of Physician called, if any, .J..; . 1, , 'Y111 'Jiu. u. {)~_ tCO-v . ft,. Ltt ti t\g 0 ~ ~hie th ~ ~1, , (/ ., and p, o. Adress of Witnesses. d:11/, P. :,l,,,. 9J 'r :{ A-0 . o r r, ' J. .,.,,.v ...; '-- - "-'hee1' I ~and extent of Accident, n~-~~~ . , ; cY (Signature) Cl,&, ~ Title, ~ f ~ - r �• -/ ~ -- I- ~ ?I" . / ~ / f • -.,. / _.,,, J ') " ,. ;4-~v '~e.-e/ t.....,,-/ ~' /1 . .; ~ ( ), I rI~ ~ ~ 'N \~ \~\ ~ �I. /¾~ ' I X , ~ ' ~_,-4';~ . <.t--l.- ~ -'/'YA • ~"-"'r- T7',_;.: t~"' .. .,,.:.,. a.<.- I .. ,,.,,, - · ,7/ 01,4/'"::fei / ... _ _- ,,e . , , '[j;,1t,<-r.--:f.4 - =:. ~ a . )~ /!'.. / ,: /--reef" )/~~? : ~ ~ ~ ,,. ,,. / LJ:.,· '.' I"' ;/2 - ~ • ,,;'// - '"' , ~ v~ c i!:~ ~ 11 ~✓- ~ "c7 , • . _,J �211 .J' Form 123. rrON PACIFIC COAL CO. •flt\ VN Mine No......................................... / ,1:I'()[\ Sup'ts No. ........ ......................... - - - - .. •1' OF pJ;;RSONAI, INJURY. s' 1 if person injured, • 3,--~ ~ ,11::~ 0. II , · . :,patI0II, " t- ½ ~ L• ., Accident, ''tc 0.1 ""\ 111,1t10ll1 . .. ~ 'c I ·,•ot, 1n)I Q (l"t{1 1 / j , L ~ (/)1,- ';L(.,..,,.,.-- ·- ; J7/, / .£.1 • '-' ci. •.,,,.,a. .,, ., -~./ ·-;;- /.l r /J • G,J-..:,,1:,t.••C..) .. 1-r=< , n J,1,,-tj .:·•--; . . , ,red ,n (;11111•, slate whe1 e, Mine No. Time ~·! JO ~ :2..,, Entry No. ;z., ~ Ronm No. t t ( of Mine Supt_ . . . d - ~, of Person m1ure , ......, 111/IIC l C/AM,):.A./ 1 /.,ve..d..lwvJ;f,r..- c,,-.,, - rhat family, if any, , ".:><_ , wlong in employ, of Co., 0 .,...--~ and address of nearest Iiuing Relatiue, o/"' --~\ rashe an efficient man, ~ -t - rwe and in whose charge left, ~ (ame of Physioia11 called, if any, f'iv~ ~ ~ ·' 9,,1 ~_ • IV~ , }, ......fe; ,:,,t,,tVL~ ,j,J}Jv, 1/il,J,vv , .. . Oond1t1on of Life or Circumstances, ~- • Name of Mine Forman, ; / . ; , . f/leffied=ey Sing! .,, ,,., , u ~ .,~ _.,,, /.,,-0 ..,~ Was he temperate, 'J.__,(,;J...,r)- ~ ame and p, o. Adress of Witnesses. ~ ht~ AfJ~~..!. ~1/--?-r.L~. kr;r-, ._,./ " / , ., t v~ . /ature and extent of Aooident, ( ~f ~ ~ ~~~/, ~ ~ f/ \} I. // u /' ' ., / \,; \ I ,J I j (Signat ure) 79'tJ.J: ;}??, } · 7J ~ r ~..._.,..,.. c;::,;- Title, �r '.l'0 IHOll IT MAY 00H0ERN :• !his certi~i es that I lln. Gibbs ,am engaged a t Sl>t-ing Yall•J, w.,e. mine Ho'! l __as Gas l'a to~ n._ About 11. 45 A. M_. t '?4&y I . came U? to __t h e ~ P.fa~e wit h M'r. Kn_ o~. My boy oame w~t..~ my ~~nner to the lamp cabin,and I warnea hb to ke•P ••1 frem the saw. ••~ I -.sin the aabin I smelled wood burnin.soand immediately - . rifte~,I heard the a~w l'Unn_ing_~t ~ tewif1o _O~OO~ol'lro~no~ an(i i ran out of tho cabin t~ see tfbat _waa the mntto~ouo fo.u na Br>a.G.slit1, I. who••• ~ing the saw,lying 4~•n. II I ran into the Engine ·house and shut off the oteamo By the time I got out,Bradsha" was up on his feet.I toolt hold of him and i~r. Knox ran :fo1., the Dootor. Signoll Om.Gibbs . ! O. \lfQJ IT MAY O0II0ERU: • . 'ibis oertif ioo th.at I Chao.Borgan 0 om engaged at Spri~a Valley . ~o mine No.1 located at Spring Valle~,, Uyo. as Master Ueohanic ,ana have oha1.,ge of tho engine that is uoed in connection with the cirole oa~. • I have n eovei-nor on this engine and it is :ln gooel eondi tion!~nd was today when Thon.Brallshn11 got 'huxat 0 the engine is also in go.ot1 condition. It i s my opinion that Mi-.Bro.dshaw go~ the sa.r1 otuok p~nd that the . aover nor opened up and. •allouocl . the cylinder to fill \7ith. .sterun,· •• . . .. . •which fol'oed the engine to rnovo, eaus ine the s~:n11 to burst antl fly . .. . . ,... . in every dlreoti on,one ot the pieces s~;iking him,making a la~ge wound on left a i de of his .face . and head. . ... 1 tl'ied t he ei1gine a~d govei-nor shortly after the aocident and found them 1n good shape. .. ... . . . What makes me t hink t he saw v,nis moved from i ts place . • t "' t . th s uait, \ • . , \ , .. I ' ' t, ..t:t e "'rame it ,1as on i f:l �k••» •Wll7 t rem the saw. hn I •s 1n the cab in I smel led . wo_Od buienif28,an<I imme« tat ei .1 atteP, I heard the saw l'Um'li113 at a territio speea r.w rr• • . •• • o_'_l.1101 anci l a I! nAY ooncmtR:Tbia oertifieo that I Jamea ri.11ox, o.m ongGged as Aas\ Mine Poreman n t Spttine Vt1lley .wyo. in mine Ho. l to4a.1 about 11. 45 oc_l ock ~.•ti~ I CQUlO up to the cir ..rfac~ ,and had , Just got into the oabin where s~~et:, lamps are .. . - ..kept. 0 When I went into the cab . . in . I aaw 1.!'l.omaa BJtaliohnw oplittinG.. ~P. pleoea with an nxe, Just. as aoon as I got i n to the cQb;n I be~~ the saw ata~t out with n peculiar aound a nd. rah out t o see wha~ • • • • • • •• t• - • • waa the mattei-, I saw aide .. Bradshaw.. lying .aow:~ .jus . t by. .the . . . of -~e • • tram• , the aaw na running very much fast er than I ever salf 1\ Nn before. • 01bb9! i-an into \ be Bng1ne Houae ~n 4 ahut off the s t eam. • • • • .. t .. BMlahaw got up on h ie r eet. . . aa I went towards . him ! I.. turned hint • •~ t o • . Glbba and I atar te4 ott to set the Doc t or. Si gned James Knox " ~-'; : ...'11•~ 19.08 ,. ,. . . • GCft • I ~ ,l �Form 12a. ACJFIC COAL CO. ,,~roN p • u! 1'1r~ r, pfil Mine No. ···-················ - • J' .pBNSONAl, INJURY. ,oNT () , 8up'ts No... ................................ I ' f!J·~ ~1'3~~ h,,ti-,w-- l t~ ,. 1 ~ person injured, ti,1111c of (;a,1.-1/ ~ / / ~ ,·c11patio11, } ~ 0, .1 Accident, a. oat~ OJ .. j /.. ~ v LoClltiOII, . . / ,J.fO: 'Ji f,1i,,,•, ate whe, e, /j t1ot 11uurea I ?a I1 • li.\.. • ..'lt • 'Of ., f,fine Supt. 1111mc OJ ' • • d , 1· JI r Time a . . ~ / / ¥.J' 790.JMine No. a4,J (,'fB~:rz,A--[I (! Age of person ~n1ure , ~ - I I i .. q /'h • • Entry No. _ _ _ R~om ~:. . _ _ __ Name of Mine Forman, () a,.,.//ur..-e,.f'Z/ _ / .t:./.. <./"~ L t/_,:_ Mamed ~ · ~ ·, t1 , /J ✓ 11 ·~ t camily, if any, ~ _,(__,,(....,~ ~ I ', • W11llfl •• I011gin employ, of Oo., ~ · . y~Condit,on of Life or Circumstances I fforu d address of nearest r ing RelatilfJ:J, 711~ ~ _,11 ('.f • . ~ •• 1 n / . fl·~ !J ti. . Name an HA • fl ~ ,,u, ,., ~ ~ /7~, I iii 5 /Jean efficient man, ·,l,)L,-f/ Was he temperate, ¾.,L {J "1'3r~ ;:ereandinwhosechargeleft, 1 1 /lame of Physician called, if any, ~ / ~ ~ - ~JL,,'_,, ~ , '/.fh.l, ---3/. v. ~ , a <U.A ~ - f --r , /lame and p, o. Adress of Witnesses. 1/ature and extent of Accident, ~~-<7)1/¥-~ z ~ ~ , ~ - ~ ~~f ~ S7 cv...v: .. (Signature) 7ftJ6"- ~ I �.• • y • I / I 7 l- t 1 ·., i ::, { . ·J l lt:'l. 1 t i. .J/ i. 1..oc;:r , \.'i J .i n1 ra .. :..1 I. e r. t \.o \;,·,.:,:-!t . 'lhcre l·w . l !.. i ne , a nd:, v:as a shot ':hat 111, \ •~r throwed the :~n · • t. ,.,,.,. s loos ~ .. y u1c- le J:U.. l t:•2 t:.l J he could out and ).i ~:\i. -: i , ',:-,.,. bottctr the coal pepped and a chunk of •:'-3 l J o-n . i. i m. '..,1'l'," ... I' ... CC'", , , '-• t.'l 18,t rell on hiF would �rrJ£ v~roN • 21~· pACIFIC COAL CO. Mine No. .......................................~ ' ,. r 8 RSONA1., IN] URY• . ,o/1'1' OJ tM ,1 P«:rso11 i11ju1·ed, /JllllllJ()J 8up'ts No.......... . .... ..._... . _. ~ ~ 7~ ;11tioll, ~ ~ --.z_ oc.cll/ if Accident, d ~ ~ 790 .tJ 011ti1 ~ C..:t:,J..-b~ Mine No. •acat1011, t I --Ci • • • d ;11 f,fi 11«·, sla e tu 1ere, If not uvro 0 .1 Mine Supt~ ( ,~ , Namco, .. d / ,1 Person 111111 , AgCOJ . I Time / / C?• >z., I Entry No. 7 .,,<1~Room No. ~ Name of Mine Forman, 0 hr _;;7 ' . C:::::X•, , ~ ~ ~ Mamed or Single ,,a.,_:_ . .,,,,,_ "Jt~..,,.-£~ ~ 9 - - -- - I L ~ - - - • / --r-- . r/hat family, if any, ,,;i .. . long ill employ, of ao., ~ Oond1t1on of Life or Oiraumstances, .___ - -.. HoLII t 1· • R I t. ~ • Name and address of neares tumg e a tue, c;:7' ~ y ~ ~~ >t-....,,,/ ~ . d in whose charge left, ~ ~~ Where an . ~ ,SJ., Name of Physician called, if any, Was he an efficient man, Was he temperate, ~ , _ cJ • __e. ..-,/ ,_ ~ ~ ---~ ~d,,.,----a <'7 , (Signature) , .::7-. ), ~ ~ -9'o-- ◄~---,---0 \ �I ; I I ' I I. . ~ I ,, ' 0 I • /, I ,' / I I ' I.., I { I .... / ' .I / I .l I I I I / ' /. II\ \ \ I \ C. . •I,. I / , I I , I ... I / , ,\ , .-, I . •! 'I ., ... I/ .., ; .JI I I \\ I l I ' J I : I ' ·f , I I t • , j \ ... ' , I �/ . ,l (j \, I I I ., I j)(.f I' g.-:'< 1•6; .. r ;:•·1··~·~ v. ijl I/ -~ ( ..:, 1··# r ,lfi. •' .r . ,•, ,1. ~ " ,·O' I . .t: I ~,: ,,, •Jia. ' ,,1••:i/ ,:;an \. 'j .... J , ·· ··.(I\; I (. t ~ / ' , .. I . ·, /· ... / '• I I ' -._,· . ..,,. "! · ·•1 .'· I . ' ..:'·· £ ·' I.. ! ' . /.... .. ~ ... t f , ~~ ...... / .I 4 ., , ' _.'i. t , - :.J ,. ,1: ~ ' hi. • __;,... .,-,e,J '• I ·..,, '. I .t· {-~, ... }. _, ·/ "'- r ~ ;I ,I ~- ( ..' I !. .<--;. ·{,., / .. l ,...,, .. . j ~~--- •J,:,; ,· ..,_{/. ,:,_,..r...... ,, l ... __ .·... . .. . .. ,.... ,:' .. ,... . .• 1 •' / ' / / ,· ( I I • l : • '[ ' ·• r' ., I r J ' .... I .,· .' i':.. 'I J:... .. , ..~ l J '··.- / { ) 'I / ~•/Qi �Form 123. Mine No. .. - 2l • ··················.,······· 8up'ts No. •••••••···· .·······-·· ....--- .... c{;_A ··--~ ~ ({ ~ f~vi.. ff 4 - ---~ · ·ured, } ~ _ . pf perso11111} f/,11111 11 •·11/1.fjOII, fl :l t ) ~ cidcll o.if.' ~JAc - ~~ ~ "l' ,' 790 5" JAbs,. 1 ?rr, MineNo. I iocatto/1, . f,1inr state where, 111 1 ' ;njuretl tJnOt 1' ie Supt. 10 0/ 1, II .. . Nan . if person it1}t1red, Jr~ j(?(/t~vv4./ 3 7-- Time ~ II r P ~ u Cl-' , Entry No. t ,1 - JL R •~ ~ , ( A.._ oom No. ~ I/- O q ,.., d_a-,,..,.,.,- Name of Mine Forman t't?- (7 • ///1. ::Ta....~/ , ' M:rt,-i,vied et' s· / ~ I --mg e Agra; family, if a11y, /': ,1 / .. Wh ,·n employ, of Co., ~~ ~ Oond1t1on of Life or Oircumst /ong . . . f /,!, 11_ _ . ances, H0111 ddress of nearest llumg Relat1ue, w~~ ~, ..£} Nanteanda ~ - ✓~ - @ ~ A A . J J L . fJ o an efficie11t man I Was he temperate :.;-------· ~ washe in whose charge le;,-Ft, ~ ~ ' •~ Where and . . • _ /' = ,tphysician called, if any, 11ameo, ;J}lv. /4 . }cl-. f" J.~ d' ~L/4-" (/ f o Adress of Witnesses. uame andP• ' I ,I I"I I f Nature and extent of Accident,~ ~~~~M~~ ' I \ . I '.. . .' . I •. / , · .. ' Ir -~ ~ ~ . - ~ ' ·, (Signature) 7 Cf{J .j-- J, 'Jtt, Title, ff~ ~ #'~ r;u,v �STATEMENTS OF ,vrTNESSES. ,I ,I /I ' /- I / ..i : ' ,I I / , -;-; I { -- ; ; w - I (1 I ., r • 1 7 (. , ' . ..., .- .,,· (.) t I 'I ') ; .II I ) , ~ ' I J I I f ( I I ✓ I'? / / I I ( / I I I 1/ ·' • I I {,· / . I i •J ,. I /,, . ,) I ( 1, 1/ l I I ,I ' . ""' / ✓ •I ,I r I ) . /' I ( ~ , , . .,-:r ~ {'/ ' I I I ,; .. J -✓I . ( l t < ,, I .,.,,.,-: , . / ; ;r" f ,J ~ • I i , ,. I r, >' ' I. / II I ,,- i I I I • J . , J \ \ t / j .,. . u ,,.-·, cA !:::. ; # r I I I I r, /1 t •' -{ /J ,-!.,, .•, , ' ,./l .I I ,. I __; / i~/ ., I i .( 0 7l �. Mme No. 21 :· •••••••••••••••••••············· Sup'ts No... ••••••••·················· . .... ~ 'Jzr ~ P "" ;11jured, _ //df;:.' ~f Cl I (/ ~~(I occ11J1'' ion, · tentI f;vt"M-J :;... Oaft {IJ ) / t,vlM .1 Act'lt , ¥ 1- q. ,rrt~ M' 190 j - me ,:· ,me N 0• I ~ r;, 11:Jo v. /71, Entry No. .,,,.. .., o L()(J(i0/1,. . din f,finr, state where, 1/110tMlllC .11,fi/10 Supt. (!; · J. ~/1,/vtrr-A....t.. . "ameo, , person injured, J-< ..1 Age o,1 . What family, if any, .,t . , ., . ~ Oo11dition of life or Circumstances, tong in employ, of Co., ..-,/.t,,v'J', , , , , ~ Holll t 1· • R I t· address of neares iumg c a 1ue, Namean d Lf. . _ Was he temperate, Was he an efficient man, ~ Where and in whose charge left, Name of p11ysioia11 called, if any, o.1-~~ j , A/, f Name and p, o. Adress of Witnesses. Room No. �l ev G··n o t .. . . ' -11v-.. " ''Y s!W .., •.~•1,..,.._.. ' ,.,-. r V~-'·••.l. : )L ,~..., Ci". f.-,'~'.1 · - -'.•:_<·, u-.-_,1--. __ ,,., :- .n.c1. _'¼_,,, .; .,..,_rr ..., ·__A.... "• •u • ilc(; ,T O •):J;:fko\Jok:l o •1;n t ,. uir. 1 L '. , o · · ~Gi"Ol-i0 o c'"-:u J~ ·.:.,..,t1• --.u I. �( J, :. l_,ly I .... .-. 1.... ' J,.. 'J j -; . 1 . • ·,, t•n.. • •·...1. 1·1·L·~ • ··:..; ~ • ·j--~ ,.. • ,., • n ;_,J t•, i t .., ., . ~, t , ., . )j 1 I-. .I.\, (' . ' . 1' '· .. I ' ....• I ; J ' .. ... J (. r' .. ' . l, , ',.. I I ... .,, . - i. r; T .,_ J_ ,, ,. ..I , I : . ;.,. . 1.1 . • , A. '· • . A. I \ A. , I r1,. I -.... ' : t/ •":..: t]. • • ·' 'i . :rrnz. i .•,., .'/ .. f. ,. .' . I• 0 ., .. ..• l •·!· ,· -~ (); ~ -(~.,.; . I .r.• . ... i, .•.- i 1', •' I . •. ,, :Lt:·n. 1< l• - "I: .. , ~. l ~ JI .r ..,. '. I • \ L .. ~ ;• '11 , r .\ XL t ~ :\ • ~•: • i ' ', l.:• l'l · 0 .. . A. ; \ l' • ··• }~V ·:,.• . i> ... t.-~ · i,; ; 1 . i)'l_ ·: ll~ .j;_::;!' ~l ;t1:r 1 • , i . -. 'iP.~! . j ( • J t 1,;:1): !''i. n-· r_~,- • :,1· .l- ,r,.:-r-~H.• . .., ,..,. ,,·,y !oi·.c ,.1. •·J.J. • Rl! ):'1'. ,, 0 rr,.i~t, '.i.~ ::C~J j:c.,or1 l' j t,..t f, ·;o . 10 :!i nc . Yr:rs . !1 0 1 ; l.O~} . ·J.1 '?"J (;, l,'1!1,)1'• • r; . '' ..-,;t , ~- Vt CC· , ~ 113? , • h 1J.t r· :~t o~e. ! ,._, i ~~ •. "C~ : ·1 t .'"",O t. -: ·, i ! ' , .. 0 ., • • t , M lJ:in'r~o-· Ri: t-,T,p•.-u.. . f\. 'I',: tu w11;: 'i'in u•;;,tny , :,•, . tt not ·1-A , y :; . ny GC>ronn,.-. :"0110,:rl Or. 1. , .A tl0!1 tH "l A• 0 1 �) ) ' • I '. .i : .'.. 1, I ' )' • • J • I ✓ : '0 I) ' . 0 • • I! . .. ':. ,.; ' \ 'e Il ·I~l'•,':'I ''"" , .., ·1•)~. ,: -iyt, •.•• ~- \ . • I r r: • .... .•. . ' r. ,· I. .. •I ., I ... ' !;; . V C. : . ... .',.,., !'1' , . (J . ·-..:r n-: • ' .. A. '. ..... t • , . J J f• .I• .I. •. 1./ • : J.l , ~ t. .. .: ~"( ( :- " - • i• .,,I t l • i .I 1·') ) n tn•.. tno �Id ) l • • ) Ia } ( I ROCK SPRINGS, WyOJiiing, 2-2-1905 . I • - • Lilly wu workiq ~1th ~ernar4 J ohneon on the ,econ• tfiP ot February 1905 . We h ad got our lr4 oar up in the room 1114 atarte4 t o 1o . .• Re t r 1•4 to t &Jee t he coal do-.." bu t could not th•11 he ••n~ under to mi ne it, When 1t tell down ancl I triecl to lift it ott h ill but coul,ct not ao 1· ~•nt tor help in the o-• onr an4 help et •• to lltt t he coal o tt him. (Sien•• > J i • Lilly next place end a ,e• �21(1 ' ll'orm I:!:!. Mine No. ······························~ 8up'ts No........................ .... . . d p•1snll i,1]1/(C , 1d, I ,, f,,Wt1,i~£-- C:...d..-i,t 4-.-r1-<-- r~ • j lil/ll t <!-1 , , VIA"' '/1tflii f/ I !J 1, _., .,1:,,11.. t v•11 Arc1tfl.'II • ' , . ",,. 4 • /,1 r< ,/2 j t :.iA · 1 '( P' L:,fi11r., . Min(, sta. c whcr ,/ a,hrz. ,:J._ ,..... 190 6 Time 1£ n M. me No. IO Entry No • · ,'-- , /"v-~v-; c,- •,;,,red in li"°11n1 /J I I} o n 047 1// , .-,,,r,. I- /'"11 Room No. 17 ..j 7 !/ . pt l ic.r, r " - /1:JA.-tr..,.,~.. " k - _ , / Name of Mine Forman 0/1 , · ~ > ~{ 1,1,ne 8u · ., , ft... / r. '-1/t:< •U A-4--~ v,.....-//ome Operson Injured, tl. f /J , 1 , Marric~~ inyte JIJ?~ Jg:of ·1 if any, (!2,,,1'(.,U c . ~ 1 "'bOl 0011 d1"t ton • of life or Circumstances "' fd/11. y'employ, of Co., 1ongm .. • J ,J/, , /J Hal and address of nearest ltumg R~at,_ue, ~ ~ _ ~--tui_- ~ ~ Ricient man, ' J,l...,<l/ Was ha temperate, 1.,/. •ct.--° 10'"6 ll'ashean 8'JI' ~ fA O, J..,c... din whose charge left, -J- ./-:J,....<..,,vl,l'-1 d / ./o/ tM...,h .'rJ.. Where an . /fJ } (J 17> I (- ·., Physician called, if any, lit-- . ""1 , V<....c. '- l't...- , J Nam, 0, o Adress of Witnesses. Naineand P• • lr.o Nature and extent of Accident, ~7 dnr}; /:3~ ~ ~ , d_,.,.., L--L, a,,,,_,vr,_,_,, ~ ~ 711 . ,co~ "' t ~' ,, JI ,. , ., (Signature) 11/J- - J-'Jt. ~ Title, fet-~ ~ ~ . �,. l '~ t,' .. ' I /,, .... I I ,..,, i.., ,,/ I•/ I./I... ,' -·. :,• . J ~ ' I I '· l I ,i / (' . 1 • 'I t'' ,. .... ·•1i1•'1.I ~, _..,,. . .. . J, l t \ 1• . J ,.s • .. "' ~ . , ; 1 i j I.' / , t :' I ,.' ' .. • I ' II ,,/ • . ·1 ' I I • I' ,,,,.1t: ·, 1.- : !,A,_/ ,t . / O~L ., ( t I '' ' c. (1 {;· .. ..' I • J r~J / .' I I , I I ,.,.,. l; .i. I ! .J_' ... {, , I ', I ' I I I I /. t' ~ ...... f .. I • .,,;, •• . . r.. I ., , ' f ,. i /6ti z.. l i,u v , ~{ .:~l· 04,. cc . c •.. l • ,· . I_ \, I I i r I' ! \ .•~ --e--1.,vf-· t -, ._I } . ' r ~~ ~'\ '. •· J I l• • I ' -' • "' '• ....., tr ;,f /' I I '/ •' I i r ,.., ,, I' I • , ► • ·' . , A.•~ i \,,,_j '.. Ii, ... •. • -/ ,(. I l , • "I#, - .. ; ·., •. / \I .rt.: \. ' . •(_ I_,.\: ' ,·/- ..,,. I• • i., \ I '' I : 4~ I I t f! r, ;/',./ L~-L•. · \.._,, , _,, , ' , ·1 ... ' ,. _...-j, ,_,.-~~?\.) t ,. I I i ~-; (; ..., ·1 '.!.. . ....... .... ,. •.. ~. �. p,\c Fol'm 12:1. [FIC COAL CO . 21 7 - -~tO,:\ I~ l • J:'ro,.•r :J?SONA L INJURY. l \ oF p' 8up'ts No. · ·ured, ,,....,•f./ nn, •~•It J / I) ,.,... !I .t ~ccicfcnt, I ,-u,,,,r.1 f CJ_-~ ~ /JI'[,, ~riA'C""" - Vr-'.~;(./V ,J • C}A-rA-,,1 J -j?✓,-v1v / ~ . - , (/ • • .t:1' • d111. t,fitH' statefwhere(/ • ·rc '' ,,. IIRJ" ' . v Jiu-. ~ 190 L1,..,:• • IJ\....t Mme No. 1.::~1 . Tune g- altrl,d-1~_ C? _'11 . Entry No. 6- ~ Name of Mine Forman, Jb'. ,p;,eSupt. , tallico, .. d )./ , p ,son 1111ure ' 1 I ,o, e -----l'r: r- tfanillg, if any, /J I J, -r Room No . '-f/J - /J '.-l.A-. ? ~ - ~ S• I • mg e -:--I, tlO /Oll9 in employ, of ao., (/l,f-rrv</f/ ~ Condition of Life or Ciroumsta 1 yo, d address of nearest liuing Relatiue, rlr//1/Vl r J ! ) ~ ✓ .J ~nces, , tamean ~, ., • \ Game (7 ' OJ{_,_,,_ , o' rr-~1- (1~ washlDn efficient man, ~•ere and in whose charge_ left, , Physician called, if any, 1 /1, ••••••••• u ,.,,,., .• , , , ••• . , •. ••• ro l!J~/1'1;(.J ~ IIA7/M· •pjtSOII //I} I Mine N o..................................... ~ - fe. V • · ' fd- .,vv,.14"':f_ g , I~ Was he temperate, )/4 -vi..1-1-d/ I' ,1-h.,,'._t;-J - Jlrl CQ.,,( , l'l - f - 01.1 &&.,,.,• , ~.A~• ~ - • r, - • ond p o Adress oif Witnesses. • • 1 Nature and extent of Accident, }- •. '-/ I ~~ - 7,,,_,_,-{_ 'f,,,a7 ~ • (Signature) �STATEMENTS OF Wl'l'N.b::;:::;.e;::;. '- l .;; Il j, l I I I I �\. , '1{!JV , l { \ 4v . l l.:.•:and Q f I le G ,J �,T ·7'1O~, ( l• ' co. PACIFIC COAL 1i'orin 123. 218. --- Mine No......................................./ F PERSONAL INJURY. rtl~•f O i 8up'ts No. •••••••••••• ······ .. ·-·--· --- ~ ,,rP"'"' i11j11red, ~~ ~ '/ ~ v .,,,(. • /. -; 1,/ioJI• f Accide:1t, '.')II, I/.. 'J. . t 1 / I ~ ~, ~ 790 j!tfine No. . I .• red in Afmt , state where, I CJ Time ~ I/ r :e,_?c.,,{ / q,,,_ 7 E • /II• ntry No. % Room No. ~ ~1- /lfl]rl J'J/. ~~ ~ , , ,/RineSupt. J ,.,,,.._,_J - ~ Name of Mine Forman, f, '} . .1 person in1ured, t./ 6 Married ~ ,;, IIJ . t:f7'"'/J . ~family, if any, :1/~ ·~( ,/,)Ilg in employ, of Co., ~ ~ Condition of Life or Circumstances i '"'·/- r1 andaddress of nearest liuing nf!atiue, ~ . ~ d f l ' - ~rvfo-l /, 111-If'•• an efficient man, ~ was , t • , • (· vv, ,1e emper e, 1 tvtand in whose charge left, ~ te' -m J- ·h I dk.. c:.:;; 1r .tiPhysician called, if any, 11(_ I ?:t' f r<y . ~ (I h'- 1nd P. 0. Adress of Witnesses. f rrv ~ / • -~ ul, 'Jl--7;:J 1-- . . fbtand extent of Accident, ~~ ~ w~ ! i d1 ;,~/Yl/-L _ I �:c , .H•l7 ·~~ i9t'orlcing shoveling coal ln Box cars at No, DW • 8 ot Janu~, 1905, when I was in the act ot i • l • a car ioor in the 'box car that I WflB -. - The first ohunk that came Wtor• I hu the aoor In place. in, v;he11 they started MIii brolce ~he door and the coal following d. t knocked ms down v ana ana l•&•• bJ~ (Signed) Henry Hanca ~ ·Jtiient Oj ' .• • ' ' .... \ •. l �t1N oNT V ----- Mine No. ········:···· ..··············· j 1 / F pBRSONAL INJURY. 8up'ts No..................................... J~~ ,o/Personinjured, Q_ iotiOII, ;;a- ofAccident, , c'>f.- ·~ ! t , · 31--,,: I 101, 21 !~ Form 12.1. •roN PACIFIC COAL co. 790.j Mine No. 1~ 4 ~ (I _(l , y Time ~ ~ 1:tt1'7L ~ r ,,,,. . · ,red in R1iw, state uhere, 0 t uU1 Entry No. R oom No • r;I. · ~ t e / Name of Mille Forman, ~tJ, fl~ , Married or::-ffer:Fgte (l • 1! Person '.n1ured, . %~ •/_ n~tt t ramify, if any, :: f o ./~ ~ ~ c,'I tong in employ, of Co., Y-~ ~~ Condition of Life or Circumstances, 1 of Mine ~u~t, J!d,,c_,,11 • I l l '" \ and address of nearest liuing Relative, i~ ~l he an efficient man, Ii 1t.1 l'-c Ire and in whose charge left, h ··~t~eof Physician called, if any, that , ~. :) • \ "-. ~ a.A-- }~ '!e,/-C-/4._,; ' Was I tempe ~ ~ -f ~....-- fl . (/J ~vy_ ~ b &&L. f l.: I1 and P. O. Adress ofW'1tnesses. 8 '-:1~~·1, ,I; ureandextentof Ac~► 47- ~ -t..£-w-d;_ ~ (Signature) 1f& ,j C·7•1u•O!l-.011. ~ ya Title, - d~- ~ ~• �STATEMENTS U.t~ �Forrn 123, Mine No. ~ 8up'ts No..........::::: .... a_,.?v- ,A:.,,,/,~!,,,}' r I d,,-·c :f / 1° }-J~ Entry No. / (Signature) yo .j - 1 4t'J--, Vf ) ~• ()%a:le~ Room No. I . ~P~- r,tte, j , �,,... I . , ( COPY THE STATE OF WYOMI NG county ot carbon ) ) ss ) AT AN I NQ,UISITI Olil' . Holden at Hanna in -Carbon county, on the 18th d~ of February Ao D. 1905, before me (Si gned) H. Ko Be nnett, Co roner of said county, upon the body of lying dead, by t he Juror• whose na.mea are here t o aubocribed, the s ai d JUrora upon their oath do say That Matt Johns on came to hi s deo,th by a. piece of slat e called a , pot hole, falling on h i e heacl, whi le in the act of picking up a chunk of ·, coal to put on c ar which he was loadi ng in 16 room, 18 e ntry, in Hanna~ mine No. 1 ot u. P. Co al co. \ I ' Accor&ing to t estimony given we b elieve - death came acci dental . :. >- ,. In t eat imony wher eof , the said Jur ors have hereun to s et thei r h and& the day and year atoreea.14 . JURORS. Signecl J. o. Holen 'Wm . Nirmi Matt Lynn H.K. Benne tt, corone r. , �Form l!!lJ. r{ON PACIFIC COAL CO. 116 ON __ - , OF pBRSONAL INJURY. 11 1;f'OJ\ ,; person injured, 1110 01 1':ll/JlltiOII, r. / I/-r.,r,;- ,; Accident, , /J (IJ 190 j - J .Ur. ,. . 1 ty ?l/f✓.'.'1//,,zt./ ~cat10I, • . 31/ ~a,,-t;f- 1f.c[}_-rtf!,,~ C) 1 ' Mine No. y ~,.,..,,,,,_,; ,,<-7-- o ·- (I . .. ,red 111 M1M, state where, I Time (Ah-t,;;t- I/ C/ /(-,,~ Entry No. / Room No. / r -t? ~ t,, f 11ot 111}I c/ f).., ~/?--__,-;L-,t__- Name of Mine Forman , .,.,,1C01Mine Supt. . . -, .......-..---::,tc ::4,.. ' " ,f Person m1ured, .;J-. 0 • s· I igeo, . _ _ _ _ __ _ __ 111g e What family, if any, /? / ~ / ' ff iu tong in employ, of (Jo.' v(Art,rvf/r ~ JU~-eo-ndition of Life or Circumstances, ~address of nearest living Rel ue, t1 ~ &'ashean efficient man, ~/here and i11 whose charge left, r,,,•f Physician called, If any, .r-:-7 , ~ / ; ) ~ SJ..J _ , Was he temperate, ~~ 12 , fiv--~="-,./4 ~ %, J,, /3 ~- -+-'d. , .,,._~ ~ 9t'. J' 7"iJ ~ and p, O. Adress of Witnesses. , and extent of Accident, ;y, upon the said ' (Signature)/~ 1 Title, -/3~. ~ F ~ ·- I �~21 Fol'm 12:1. ,.110N PACIFIC COAL CO. t16 U.I.'< - - -- ()} '1' OF PERSONAL INJURY. Mine No..................~ · Ji'/' \ .1110 O,f parson injured, cCll/l(ltiOII,. ~ilJ of Aoc1~ont, .ii_ ~/ vJA?u_#✓/( , 8up'ts No.......... . ......... ........... tf.J 'rJ-7~ !f-bf/-. / ,7--r ocation, /?.A~-~,,,.v,xl , 7 ~~rnot i,ifured Ill Mme, state where, , ~·---r 14 A ' ~ ~ 190 j Mine No. Time 1 f.:. o/. tik;t- # Entry No. / t1 ' r ~ Jr Room No. / t? /0'; &J ;.z.,,.,,kf / J A 2r z--<--- Val/IC of Mine ~u~t. ~///,,,_,-;!_,£-- Name of Mine Forman, l cof Person IIIJUl'ed, ~;l. 6 • Single {/ g 'I ,£ What famt y, 11 any, ' HolV tong in employ, of Oo. • ~ ~ 15ndition of life or Circumstances, h t1 Y.f ~ - ~ Was he temperate, ~address of nearest lioing Retr,f{oe, f'as he an efficient man, Hhere and in whose charge left, Name of Physician called, if any, ~.,,,fl z / ~ J \ , (!_ , fl-v- ..,~ /,-,,,.,,;!, M •r ,,,.J_:,r- tz:.-o--Uij;, <Ji: f ~ ~ and P. 0. Adress of Witnesses. eand extent of Accident, nty, upon - --- I~ I • the sr.id It 1 I I �. . ..i' ..~ .,. I, • - '~ -=r.t= 7· \ • ~~ ~. t I ' -:·,.' I t·• .- ,3 I ~ M' ~ /cL.. /' ~ •t,/.. ·{ t>';'.,_, ~i4"1· l,,' ~-·: • I.FJ- a. l._ (f .. (.,,~~ I< • A.. "• (. •. I t_ t·r: _,,-V • t.i•'.," • • •..-/ .,_ ' .,"' - I · 1 .• I ., .. .' ' , r I ,,.-;! r-:f:~,. vl~u .,,. ·1 / (; ,r. •·t~.-vtf' 4~ I ;.J" 1 " ,., ..J.., J\J l ( .' ·, l \ �_,,.. I I /, ( ( . ) L 0 vi.!~ ,..: ·, , ~1 r , ,f_ rr, .,,,,/ '( .-! , ' , ..(_ ,::2.. ,., ! I { ~? ,7... .,,f .,, ~ l~ ~ / •"'; - ;. ·I ,w{. ' I' ' ,i ' ' ''l') { ~ V• ''°! . , 1'tt./ I - , ~ • __• I ;I I I ~ :rJ j :,,,4 l <. ,,.,. ' .. I / t' l; ... '1 • -=r ... . . n (\ I • - -. •,..., ... ' 1., ' ' :. ,,:"}i_. ,.,.., ,~._ ...J .' t I (,'I,. ·C r:. ~i- ,cf I v ,: ~1,.,,r-,•c.,<-L-~ r. • ¥t I.._,.., - )t • r - ., ,..., •,,. ......, .. , ,..,,,.,-~ ~{.-t 1--! • ('- · -:l.xe✓t Q t·r' tfcl ) ; • .. .I .,..,• . • .• .. , I I m,1, ,, _.;'l. ., ' I ~~A) i'• p I • • ~ l .,, ...Lr: \ I .- -\.,.,.1, _.., C DI ~ .•, 'l ( .,,,, .• 1 - I . • .-: . . J ./. •"'1 . .' • ·, j ·• It - ·;• ;· ·,• ,; ..-;... . i", ,.J .,(, o.J.M I ·•:•, ~ ..z,.j.. " d I /· . I' I·' t ~· .i~, .. , ~ " : .., • r· .j ' " ... I I-...\ ·'I ~./ '.':'.,r .' :., ·-, ;• 1 !' .... ~ ..... _,. I / I ,.-/ r ),-::,-/ .?? -;,) {,' .. ' I ., \J•J, ·~J • ~~i, . ,,, t r. I , ;. I ·.:~)~ .' 'J, I .1,. ,1.., . J. •• • 1 + ~ r,-1 .., .:.l~ ....,, , v I t •. (. i,t , r~ • 1- f (; t,,•, ~ -.. -~ t.. 1..,.-,. ~ £1. 1,; , i I I .. ;., ,·.,,_ I ,,, :t ~ ,_ I t �Form 123. n~roN PACIFIC COAL co. :1JB u . -~7' OF pBRSONAL INJURY. Mine No. ql~·pOI\ 8up'tsNo............. . ~/ 1/ . . 1Accident, ~- / ,O(lfef0/.0/1 !I (// ;J r7i , / <1,- ✓ f k. ,rt:rv0_,. -1-- Vf /J?A.,,r.x.-- v~.,,..,,~q_,_ , / p-r,,y,-u ~ • • tlcCLl/Jat1011, 1.:,, ' /7 d ,f person 111111re , V(l//iC OJ ~ 190JMine No. / J --::- !i:,\ A :,,.~ _. , 7-r':f-v- / •:,"I, Loc!I ' 1 . • ', t . ,i,ired in Mme, sta e whe1 , {I • 7 ti, Time ti,~,,(,;1- ,/I v- i d,,~....;{, ~f(. E11 t ry No. V/"./' t Room No. J / '-i, If 110 II~ ..,, 1., N"'' of /line Supt. f j.,r_,, • / _ f:il~~ t.,.,,,,T,.,/i Age of Person m1ured, . .1/ Q./ Name of Mine Fo,man, ,I_ , ~ ~~ 0 "· o(_",,ro . , .J2_ , ~ Marrie~ v '-'-7~- ( .. What fam'.ly, if any, ?:i--<;_ (}.,,-1/4~(/ v~ HoW tong 111 employ, of Oo.' ~,.;;t;- T A ~ Oondttton of Life or Circumstances, )'<- , l name and address of nearest liuing ~elatiue, JCCv='-~( cvJ, ;[L_·~,,./_,,,.,,-;~ ' lt,, Cl , Vias he an efficient man, ,,,, ' \ Where and in whose charge left, ~ ~ NameD/ Physician called, if any, 1 ' I r, ' Name and P. 0. Adress of Witnesses. 1 ,J, ,. ) t<l,LA.✓,- /0 u ~ ,b ft;.,..,,, __,l.., e,'-t:-~ //VIA" 1 :? fe . 9 ,1_L , . ,1 t,J, , ,,(, ~ 'I I .I' f. Was he temperat~, . I I l C , .:r\ .. .. , ,,.. (Signatu,* • v • • : 1ftJo- Title, ~ :l.n,#-y- ✓t!{~ �Form 123. •roN PACIFIC COAL co. t86 UN --· -- Mine No. ........................................ ,r OT•' pF,RSONAL INJURY. Rb'i'OA 8up'ts No .................................. ~ ~ ,1 Person injured, '~ Name o, ~~ occuJJntion, JJ tlt1, 790 0 oate of Accidc11t, } a,,u,<.t.:~:z I ry LC1cntiOII, f?,,,~ ~ - - (f - . Mine No. . ·urctl in R1in,·, st te wher(j ff not Ill} c__ 1 Time Entry No./ lfif Room No. /y ~~ .1 /,fine Supt. ¼ , · Name 0'J I ,1 Person injured, '?-0 )go • any, - - - - - - - - - - - - - - 'I/hat'JFamily, if wlong in employ, of Oo., ~1vt-v ~ Oondition of Life or Circumstances, Ho a,,d address of nearest liuing Refatiue, Name Was he a11 efficient man, ~ ~ Was he temperate, Where and in whose charg~ left, ~ ,,/l;;t~ , J ! . . ~ Name of Physician called, if any, ft. 9 ~ ~-v ~ Nam, and p, o. Adress of Witnesses. (Signature) 17 ,,r L. ~~~ (J ~itle,~ <7-~ �... Ji'flb. 28 J 905 . ~,o' J, ,. £lack, supt. coal co• • Rock Sprei.nga , ""1°• J r-. r :t e re ,. ..inr; t b t he a t t a t ohe :_l wo nl d so.y t that .I i i:l not I ~port this casa on rorm#I5o ani only .11ad.e noto o f 1 t on ror. 1 ( ! !3 4 This boys pathewe appliA:l to :'le the nignt or F h O IO th ror some lini!nen t fu ,. thB coys toot, aayin~ ho ha l 1 t sprained a l ittle ani thlJugh t it. no t no cesaar,, f(J~ ::ie t.o callo nn nel.,/ 20 th r met the boys Fathe,. on the strcot and he a:lvi ae .l me that t he boy 11a:l hai a fall and hu14t h i s t'oo t whUo a t ho!!W ,at a place whe,.e ho had ~ a neodl e in to it so.ne yoa,.8 ap,o . As I was mak 1n3 a eall by t ho houao tho fo l l owing :luy T )-{h(/?; went in to see huw the boy 11 an:l founl him wal k i n3 about t he huuso , aivi set' !'lest, . put on a .lr-e suinr; an.l gave him o. pair- c ,,.a tchcs tlJ u se t o~ a t ew days. Sin ce which ti.no he hus anj s~ P.1t1a ~ tumo,l tho ct9U tchos we l l ar;ai n. The boy hn,t l ikoly aurre,..od a contusion of tho Fx t ol-nal ·nal leo l us which is not aor-ioua, t ut ~4.uireo rost an,i cnro Pl oaso nivi oo it' any t't1.,.tho" ~eport io doai~d J,{o at 0 0 t !!'Uly , ,U A - ~ / , C(/~-~ ~ , , , • -- .. \ �'!ere,.!'i~ tla t h• a tta tohe :l wonl.\ aay • t hat thia oas• on rormft5o anl only .,iad.e note O 1 iii n • ot r it 4 ·-/ - ~. I :> ' ,f ' )I I I ·I \ ( f / I t _,I I • /. lr I / I; I t ! .. ~ ~ ~ , / I ~ ;r I I- I - C-' , I ~.I- c-~ Le :fu A ), I ... ~.. , ~ _,_ I I ,,..-r:,.. ,2 ,.,,... , l. /} .....-.,;;..,,,'{ . - I / .J. , J. ? I • I ,. / :,,,-,-; I \, . , f ~ .l ( ,. " I' .A •. I . f ; - :' ' • ..,. Cl f~;,..t:.., ·~ . -. _,__ ..,-1 �.., I .. eo "l ck ' sup t , coal co• J, ., r, a ( STATalt.lliJT Oi' INJUREJ) i,:AN • TO WH01' IT MAY coNC.ERN: '1'hh ce rtif'i H that I, Richard Gibb8 , am engaged us e. lliner at Spr ing Valley Vin• • ]llo. 1, and -.vo.s work ing i n Roont No • 3 Which is turnet oft th• 11ui11a1' on the morning of y bo 10th, 1905 , About ~. o'clock · A, x. wu bueY setting a P r op to protect myeelf from l oose Roof and 1 . . coal wl'lich wu ready to f o.11 after I ho.d got .t he Prop i n place. 1 I h it it wi th a Bledg• !{azmr,er o.r..d finding lha.t I could not dr1,-e i t, 1 wu i n the act of taking 1 t out, oo to d i g ti. l i ttle out of the bot- ·tom to l et t he ProJ c o up, when th loose 150,t orial fell o.nd hit me on th• hip• Which brui••d my l eg a.1'ld hur t rriy toot aomowhn.t. Since then I haTe been walking arouncl on 1 t and 011 the 18th I fell off a. chair off the Porch at the Hou~:e a.nd ma.de i t pnin me somewhat a.t t he tilte , otherwi •• i t t eels the amne a.o 1 t wo.s b ef ore I fell from the chair, (Signod) Rich.0.rd Gibbs. 1w lv.1. ..... ' I' J ...,, ,r :, ~-!_ ) / ',lt ·Lo .t.. ✓ ,, '-'• ~ "t Ol 1~( .'I-,.7.,v I• I ~. ,, ' .: ./ ,I -J.:-. - ~~ .., f "I'/. /'~, 4 _;._ < J'v~ ·~Ju I, ,~f ,. ;I ,• -- - ., . t.-..: ~ '" 1 .~'.J ._ v-t, ~1 ~~"½. I t . 1,,..1 • ~~~)J,{] I ,,,. ' "1->-tJ ~ t-i~---d ) f. LJ. Y. �,T (J~IOi-. fJJ]) Forin 123, PACIFIC COAL co. - - --~ OF pERSONAL INJURY. J?Hf'VI\ T 8f!p'ts No ................. ................ ~ ., person injured, ,t_;~.1, f/lf/lleo, ~ occ11Patio11, r1T-:uf,._ / t! ~ .1 Accident, 7 ,.(_ 0 oatc 'I , catioll, L0 . . e in Mi1 ,, state whel , ff ,,ot 111jUY A~ 1 /,fine Supt. ~' Name of Mine Forman 11an1c 0'J ' . • . I gz.._ "') v_ fl ' 1 if person Jn)III er. c?-' . / ~ M,vried Gr Bingle AgleotfamilY, if any, ( J ~ , Y ~ ~ w,a f .. r /oog in employ, of Co., O ~ Oond1t1on of Life or Circumstances, Hotu d address of. nearest liuing Relatiue, ~ ~ ( t✓ , _ / .+ ) J / , (}~ name an vt. . • /~ ~ .v~ Y 1 was he an efficient man, • ~11 . Was he temperate, 't_L nd in whose charge left, ../~ r?}:--~ Where a . flame of Physician called, if any, ,i_Q/4, 'i,, . ,,P-j, ~ - t - n-v <!J::::J. :J. 11 it;- _/'l' 0 c/- • r111at ,. 'hich 1 • I I~, I o•c1 • oc1 o/ • Name and p. o. Adress of Witnesses. ,oe, loor ~ Place, I ,t drite It,. Nature and extent of Accident, l~ / ~ l - L ; - av&k ~ - t ot the l" nd hit ti t }\ Since tt11 ft a ch&ir )J / I\ 1 the er.air, _/. '4 • ' ' \. t the tlt11 v / ~~ } / ,1· I ' I \: / ! , )~ I I .,, , l //I ' ~-1 ,, .I I 'I ( f I ' ( i I ♦ j ' (Signature) 1ftJ.j"': ~~ Title, ~ ~ �STATEMENTS OF \VITNESSES. ST.ATJ'N"_nTT OF IMJURE.1> lWi• Rock sprinGB, wyo., 110.r. lat, 19 06 • TO Mr. Geo. Black, sup 1 t u. P , Coal Co, I, s. uagi, native of Japan, agad 40, marriedi .or111er' 8 Helper, eincerel.y 11to.te my acc ident occurred in the mine on Tuesday la.at that \"rhilo I 'tlaD \1orking in the room NO. 1 i n Mort 2 .Entry, t he lo aded e r.re owne down :rro;n ol)p oei te d i re c t ion and atruok my right l eg. Witne• • = H. Nishiyama. r '\ \ \ \ ' . ·: \ �STATEMENTS OF \VITNESSES. STAT.rf,{.ENT OF IMJUREJ) UAlf • Rock Spr1ngB, Wyo., Mar o lat, 190S, To Mr • Geo . Bla.ck, s,.1p • t u . P. Coal Co. I , s. ,Aaagi, native of Japan, aged 40, marriedi Drille r' 8 Helper, sincerely otate my accident oocurred in the mine on Tuesday lut that while I woe working in the room No. 1 i n North 2 .Entry, the lo aded cars cwne do\1n from ol)posi te direction and atruck my right leg. Ro Asagi. Yitne•• : 0 .,· . ,, . . I r .. . .,,· , I I . ., J- t • • • t I .. ' I I . . .. , I I : .. - I... I ' . . . , / •'t I .. , // t •' ( I ... I : _, ... .. . . i I .. ·~:. I I • ~ I • f ,_ ' ( I , •... •• l I J I ,. ·.... , I I . : ' . i-: I ;. I ·- - .. . J . ,, , L . I • ' • -/.. I ' ,, • I I I ' ··-·/:· J I :. I •I ...... ......, . ,, .-· ' ,, ' ,, . . • ./ , I .., I ,. • I I •• •• 1 r f I...__, (. ,· 1 l . . . .... �;, 1,'orm 1!!3. :,...1\. .:- t1N tO.N PACIFIC COAL CO. rll•~ lo) - - Mine No. .. ................................ ~,;roRT OF PERSONAL INJURY. 8up'ts No ......... .......................... of Person injured, ,·,,me . 11LJ, ,cc11Pat1on, 1 -e/ ~~;__ ! ~ _r (;;: _; _ 1 ,1_ ---~ v - ~~190 .:JTime• a.1-,,,d:: ..J O ~_,,/~ Mine No. Entry No. ,:f. 11cn.4,u-,,,Room No. 111 -,,u(.... .\lte ~f Aoofde4'0",t, • :J-_ ;J- ---;;- , toc11t1011, f(tiO t • ,1 r (tA_ . ~ r - ~ - iniured III A1mr, sfate wher/, 0 11111 11 . . Age of Person mJt1re ' 1 ~_,. ~ , of /,fine Supt. d--&,...,.,. · r/:1/. . . J3./-a.Ak /) 114. OJ .J?J. tf7' , , Name of Mine Forman _!2 ¼ -, _✓ . .:) -?'~ / --, ,<:.; ..--t r ~,.,,, // d. / / 1 - ' y r ~ . Married EH. Sln:gle. ~ ~ • ' -rr, 41 IYhOt fam'.ly, if any, ✓~ .-vt,'( n th, llt. HotV tong III employ, of Co.' ~ ~ D ,??~Condit~on nf Life or Circumstances, Ila, l I '11 ,.,,, and addr'.ss of nearest humg Relative, 9 ~ ~ • ~ ~ Q_ _ , _ ~ ntit\ ri,s t,e an effie1ant man, •ct1on Ill d o·•,..r& - W/Jere and in whose charge left, /tame of Physician ca~led, if any, Was he temperate, ~ J - /2u,,,~ ~',;I_-_J_ 1.J),u. 1e. _j..,1 a-i..~r(- ~ - ~ Name and P. 0. Adress of Witnesses. ratureand extent of Acoiden~ - < ~ ,-;,-f-:£,/U(_ ~ .' I ... ' ., • ...,. I ' ; . I (Signature) - ~ ( , , , ~ C,~ , - ~ �p 8TKf (Ddff OJ' Il11nl™ US' I ... worKilll ia 29 R•• 3 Jatry, 3 Plane, yeaterd~ 1 . • t ~ about JI a. H• I had. fired a. shOt ani pretty soo11 went b I: t 0 • wllat it ~ ...... •b• I ha HU.ruled. the root before \ ~:l Ir.' I ..-1n laloc:tecl on the J?oo:f' thOup.t 1t •• soli•• , t::v Oh t tuld I ftor f:lrin and a Jry partner, Joe .Audibert, hollered r or Ille 1ar,e pieo• ot roek tell on ••• th• rou wu b•1inn1ng to tall but I ~nz.s not quick e to 100k out • . •eo - . • M~ to get out _ot t he_•ar• JIY heat ~• cut, my chest and lego bru1ze4 and 1111 l eft hant Ollt e (liane4) Adolphe Guibert. Katureand ! ' / ..,, l 1 ( - , i : I • \. \ A :\.1..., l - I , J ;. ' ( If I ! I .. ( . / !, t l :• , I (/ • I :,. ' I '. ... I I , ' , . .. , . . .,, , · t .· ! . • I ' J'. ' . ,, ' ., • I I } • I • '• (, i .. , • ,i I i :,,.,, , / [ .·, .,.. . :--/ I { -· r i .. '· . ,,.. • • •w .., ·,·,, ·f : t' ' .. ... .,, ' ,. ' t ( I..: . ' ; .I _, _, ~ ·: : ~ · : ..~ {t . : l . . .. ... . ... I : \.. ' ·, l ,., ,•. ' J I ,.;" I l •. , ~ • / _,,. ' I ~( ~ =._. ' �~rO . . PACI FIC COAL co. , T ~ fJfJ; (Ji Jll:'f'ONT 2 -· - - - OF PERSON AL INJURY. Mine No. ...J I ·········.· ··--········· ·· 7· 8up'ts No. ...~...... U~ ~ if Perso11 injured, . . pntion, qz /J 0 11 f/flnl:1° 6) (' J\ •. ~ ,;t:; 1 -:;., Accide11t, ✓ ~ 1r.~;;. q ~t 0 1t~ ll1 1&~ , lrntiOII, ~ /.D . • din Mine, state where, I 190 .J - ~ I r . Mine No. r r:11ne I' ' I I/ Mt 111jUfC c/-. fl 4 if /,fine Supt. 1::f~ d : ; ;p,,son injure , l'lhat fnmil!f, if any, Name of Mine Forman :d.,_,____,,,./'f ;L_, Marde~ •• 1//h!J&. __ ~~ ~ 1 /{qlll Jong in employ, of Oo., KaTIIB and addr~ss of nearest l1u111g Relatwe, ~ hean cj]ic1e11t man, Was r/htre and ;11 whose oharge left, O.r p1,ysicia11 oalled, -~ W, .,'h-,__,,, , ~, if any, Oondition of Life or Oiroumstances ~~ ~ - /. / '. ~ ~ .J.J.L 9- _ ~ ? ,, r ~ h. _ JI . as 11e temperate, ~ ,~ ~ 7 ,/fl 1 ~~ ii I Narne and P. o. Adress of Witnesses. Nature and extent of Accident, . I/ ., . I . ,. (( ~, o/Ov><-d, d.,,d ~-!fZ'~J~ ,) ',/ I J~ 4J1' I ! I I • (· II ,I I r ., • I (Signature) ;I �.,.'·I• S'l'AT.EDT 07 WITB.18~ to IBJUH!' OF S. HON.QB . 1 • • ._1078 4 • 7 - a clri yer in #2 North £nd, #e Ki ne, 011 About 11 ;&. •• t had pulle&. t e'btu&r7 Utll, ot s. Hondl wu worki • I l ON• rou on the root, and t old t e J t :t h • 1 _, bt th• - e up 13 rooa "hen c .........-.1 P1e·c, ot ho tter t~, 1t . . . . 'bV.t he jv.at kept on puhinc hie car closer to the face gett1~ rNQ to 10• •r•tty aoon th• rock dropped on Honde 'a hancl Jrhil t t M ••• - reat1a& on the CU'• (Si 4) Soae fingers on hie left han4 J1 :sornoro Witnooa "p,i~ ',i lffATIIID'l' OY PARTY IlIJURED • .,.I To Kr. oeo. l!laok, 8uper1nt• n4ent, Th• u. p. Coal co. I , s. Hon611, no.ti ve of JGp&n, t i.. Ki n• wo. I • e 30, oir.gle, work1n& in a l oMr (check Bo. 54) hereby atate That on Yr14q 1.aat U t h ult., while I wae wor k i n& i n 10 • 4 I t he rock u l a.re• M the aiz• o'f a car f'el.l d own on my 1• :tt }lall t he llort.h a .1nt 17 trylq to puah i n t he empt y car i nto the r ooll 'llbieh ,... »1• •,. on ti. ~ • o~ t h• car, cutting three nnger • l ••••11A. th1N, ... tourt.h) and. th• middle finge r WU ba.cUY _..._ ( 8 1pe4) 8 . Hon4&. •1i �PACIFIC COAL co. ,T 1 tJNf 1 O" rrr» - - ~r OF PERSONAL INJURY. RerOT\ _J ~ .+ person injured, f/lTflll?OJ -~ 0CCllpr,tiOII, ,., Accident, O(l(COJ . lo.,nl/011, rrz:_. / -;_;--;.!Ar, "" z.it ;;r-tf-;; a • .. red in Mine, state where, , /: I, .....,..;tf'; ~ /I /]. .. /, ~ \) - I ~ ~ • 790 :jMine No. r Time CAkv---.z:t_ ,,,,,. / - L . . .1e A ~ tr I < /J JJ !~ Entry No • .J-'1- ~L..,.,< Room /Vo. .3 If 11ot 111)11 ,1Mi11eSupt. Name o1 ., Person injured, ~? • ✓ ·-f:JL-~ Name of Mine Forman, ~ &rried ar Single /1\ n, ~ _ ,.7 v • ~ ~. _ _ 11h11t family, if any, -__,1,. HtU /o11g in employ, of Oo.' alv-J J/ ~ Oondition of Life or <Jiroumstanoes 0 d address of nearest fiuing Relatiue, ,N~ q ' /J , -rJ ; ~ ~ Name a11 . (r ~ 1 : 1 - - ~ /t:,,rfY1v was t,e an efficient man, ~ ~ Was he temperate, ~ '-r'- • • 9 Where and ill whose charge left, .,, J ~.~ try_ /4; -:r= J • fl~'!of Physician called, if any, fl2., ~cf- R ~ . 77---~ Agco1 A-., - , rm--~ JI JlJ flame and p, o. Adress of Witnesses. /lature a11d extent of Accident, ' ~ t ! / ' ~ ~ §' ~ ~L- ~ .~"-'~ 1 -~ ~ ~~ J,~ ft},,i,w, ~ ~ --P7/l- Ct. C (Signature) ·_ A _/J - ~ 7- �' �r J, Jl~/d~, ~ . ·~ d,{~, ~71 lo p 'v ~ ~ /U. ~ I ,. I wll f..., ~I vM~y . t?n,: ~ t , ' - - 1 • d <l.A,<., au a-(' <'« t,~: n //: J,, l kfifll persoJ umi!Y, nine 1~ ndadl an efft .1ndin i if pJJljSI I \ ....... • t ! • �229, ) . l TNlON PACIFIC COAL CO. 11rh ~, __ ___ ; ~fi ,;.1111~• 0'J.1 Perso11. injured, orc1111atio11, . i~ · ,. ::- ~ ~,,trofAcc1de1:t, 1 Mine No. .............. ,::J'/ I 8up'ts No.............. _.... J J OA f- d ~,AL-- .J1'r-✓ ~k. /I{ - L - Time ~ l ' v v f //:3~ (j; Jt,; •catioll, Cv,v//1/vl..&i.,,,?-..k'",.,,~ , Mi11e No. ~ Entry No • (,I£.iiC ~ -,f-;::-R ' • /I(), • u . . I ,, 7n,U1., t<oom No. L ~ ,:ot injured m M1111·, state where, 11 ) ~//dme of Mine ~u~t. /J~vt~ Name of Mine Forman, ~JAge of Person 1111ureO' - rf 5 Married or Sin'{!{ ~ w11at Family, if any, - - - - =~ - ~ ~ow long in employ, of Oo., / % ~~ Condition of life or Circumstances, .-tJ ,•ame and addr~ss of nearest liuing Relatiue, ~~~, Jr?-fr"'. __ ( 'Jvl-- ~ ✓.~ ~as he an efficient man, Was ffe temperate, ff 790 ~ <Jn-~ ~ .Jf-l. iJ.. -/(3 ~ ~ ,here and in whose charge left, --r'6 ~ h-~ I... vame of Physician called, if any, ~ J• ~ ~ . ~_,__,,_ _ I vame and P. O. Adress of Witnesses. ~ J L ~ A- ~d{ 1/ature and extent of Accident, # ~ ~ ~Jv, 57 1--. ~ ~ ~ a,J_!_,, ~ -L,_,_,_ • -/9-A Cause, (J fl I, /j}i (Signature) 31?jf3~. Title, c.7.,:;.o:1-.u11. ~ .. ....: .. / f'ORT OF PBNSONAL IN.JURY. ~ '--~ , • ) ~ �It �- v~roN PACIFIC COAL co. ,rJJ~ - NNpoN1 2;1{) ~ Forin lll3. - ·--· Mine No. , OF pERSONAL INJURY. 8up'ts No .....................~ f/fl/)IC O1 parso 11 injured, ~{lti0/1, 1,1 , -..f 7 / / I •-·· /J J2x . J VaA. ct_ef~ J.. ~ IU._f ,,L /}~ i , ( ·<.- <-7' 4.._.. J} c / ~•.?0 f<'- r~c-/q_} ocoll/ 1 Accide11t, 7 r/a-c--t-ll- '3 ?::'{ 790 6y• .1 # ,1me C:i;?r-u,,? q : JO , r t e/4-c 011tao atiOII, ~/t,-,--AV{<U vi V'?/r ' 1--7,,?--r; Mille No. ~ Entry No./ ;(U?, J4"Jr,,.~ lloom No. t,--;,t_ Cu~ Loe .. ,red in Mine, stat where, {I If 11ot ,,v1 . ,,t____ 3-J y a(. 7~ , / 1 Mine Supt. Y.e.4 . Name o . . d ,..., O/ .1 Person m1ure , ,,,,-.. , Age OJ . V1/1at family, if any, .___ _ __ _ __ __ Name of Mine Forman, -6.-v-. a. J~ if'" rj~ - Where and in wl~ose charge_left, Name of Physician called, if any, ~ ~ v v ~- "' -/ ~ 1/ • , 1-_,,..v z ~ tvvi,,-v~ , -~::_ ~ , '/ I II I r,~ I.I;,:• J.). I ~ V•,-' ,v ' t .\ (Signature) •~ Was he tem1>erate, ~ ,6,&-n;e_ ,_}~ - ~J__ ..,;.'L.....,..r ~ - ;;I€. jJ Name and p, O. Adress of Witnesses. Nature and extent of Accident, t.r..--~ --(/ ---~- CR.- ~ Mliffriefl fw Single Hoiu Jong in employ, of Co., {Zt--F-n,,? ~ , ? ? 1 , - - ~ Condition of Life or Circumstances Name and addr~ss of nearest living Relative, ~~~ Vias he an efficient man, ~ g . ,J ~ J/'° ~ �Re C C' .:1r i n r..s ' ,. yo: -r.:..rch l o. , 'o· i) , ,..,u_. t • <· .i. • : e u . 'P . Cc i...l Cu, 11 ...._n-, • ..11i le I ( ..hit"' r ~.n) to 1n ild <,h . . o c tL , ·,11:ilc I .: ....z 1- 0l<li!1[; it, Ln(.\ 1 'J , I • ., i t h my loe),rt ncr ,:r . c rt,, ;, r • l•vst •· u.z hcl!CTic,r i ng the 10:..t •.i E t.i I!l i,, "1 C: ~t~-uck r-1y f or t:n:"d •\. 'i' - ,. i tnezs : .-n •·I, rv -'i-2 ' ., . y t ....'i c.l. • ~l. J.• sh1· • ' �Form 123. rHE UN[ON PACIFIC COAL CO. Mine No......................................... J?ISPONT OF PERSONAL INJURY. ~~ 8up'ts No. .................. d.7:- 1_ ..; Person injured, q.,,-7 Name O'I JJ / I tc.//~~ _ occupation,. ~~ ~ . 0 , Aco1de11t, ~:...l-i . - • I cJ ~ 190 6 oata 'J ~ '~ ~~ Location, 7 , ~ Mine No. / iniured in fl?in,•, state here, t If 110 ~ . ~L {J!.»f, Tune ~ 3 1 r 1 Entry No. ;).___, Room No. o ~~ //I ~ ' I-r2~ ;1 t1 N . • Forman, (A -+-Name 01, t,7ine Supt. . . ame of Mine , Person m1ured, ;2.. 3 . -: • . --~ Age 0'J . . • 8111g/e WMt family, if any, - - -_- - - - ~ /onginemploy, of Oo., ~~ oond't• ,-F • I ton OJ HoW Life or Circumstances NameandaddressofnearestliuingRel tiue, ~ %~,'_,.__/ _ ___ . ~ , ,, /)eanefficientman, ~ rT - ·-~ v ~ ~ h , . ·~ V,;a8 q_ vvas e temperate ~ Where and in whose charge left, fo/__,,,,,,;,,,..,t,,(..✓, ~ .,,.~ j ~~..,e Name of Physician ca/~ed, if any, £. J-J. ~ ~ I (/ -- ~ - £ if -riy f orer :ti Name and P. O. Adress of Witnesses. Nature and extent of Accident, ~~-rtz~r~~ ~ fi /· / ) 01/ J \_ }) \ / / • I I i '' ' ' 't 1'l-,, .. (Signature) T 1/tJ._j_.. SJ. 'JI. ~ - {/ ~ QA I - - ,. Title, / ~ if~' I I ' �STATEL\IBN'fS OF vVITNI~SSES. / ' I I \..,__ p ... , ·' ' 1J . I �Form 1!?3. ·JON PACIFIC COAL CO. tJIE Ui\ - - Mine No..........~ ........................... , OF pBRSONAL INJURY. Nh°/'01' T 8up't8 No. ... if parson injured, ([)/ d {()/.~tJ-u..,,, - !!/X~ _ «} M,7:]l;'..,,u. occupat1011, .d t r/1-~,,I,.. - / j ~~ /.'(111111 0 . 790 v - t of Acct en, '7,..,_ . _. ~:C:tion. Jal- ~ ~ • L - - 0 . / . , , . . ~· . ·ured in tf1111, slate_whe~re, ff 1101 Ill} ,!I} f/'l(-u/4 N•" of Ali11e Supt. .1- VJ J / ', .?- @ • . ........... / • ✓,... # R1i11e No. . /J I 7,,-,.,,, 9 tr /~......CV'r'..,,fa/ a. //'/, Entry No. n:-',,/_A. /,, 7 r•.z. Room No . 1/ (f2, VT..,L~ ,J -«/. •1/J......rf~-<- 3 .t- Time u.+zr,--c,,,r, Name of Mine Forman, {P Married ~ Age of Person ~JIJUred, (72: .:u camily, if any, J 1 ~--/J l'/hO t ri ~~ (}.,I H tong in employ, of (Jo.' ~~ fJondition of Life or fJircumstances, ow nd address of nearest liuing Relatiue, 7-1- ()l.,,r,,,f/t,,/,4..J (J,,,,_,~ Name a r ,.,· ,Vas he an efficient man, .....e.A../ Y.' I Was he temperate, nd in whose charge left, ~ It'.here a CL 7£) J _ Name of Phgsiolan called, if any, fr, ~. a..-1. ,C-: OJ . -!,,.,/, , . . ~ ~-,,,,._,,-..;;. riA :::_; ......e...<t_ _ -·v -o 7 Name and P. o. Adress of Witnesses. ; I Natur, and extent of Acoident,~ ~ (Signature) i bjf ~ ~ @4~- /) _,_, , !L'~ - Title, ( J . J ~ -...., �. \.•v J-4 °')v ',.. ./ .or, J ,..,/,, ,, . I ./ i.(: ~ / U l /) . . I I , \ ./' , I f I \I I , J A/1 "' . >· ;. ' ' \, f C I•' • 'V ' • ➔- ·:"' \ ., -+·' ,. I } ... I '" J l (, ' I I I . ¥ ...... I' '.I ~ .'\i \ + .' f I,}.___, I I .l '..- .\...Ii '- , .. •• .1,, .. _ &• " L f {. \J I •ItI • I - !l ' .- 1.* \J ' •l I l , ./1 • \, JI •~ t)... V, J I I '( ., .. . .' (-- ' I ~ I I I (l· ...: ~ I ... I ,I ·\ l i \ - . I , \; \ I I ; . " .. i ' .. ' I' ·) ' ,11 i. ,, . ''~J,\ l • -~ / ,..,. ' ~· j \ (,( - ' '1 I~ I , .~ ,, 0 .I ~ _.,,\:.," i '! ... ('· . ~ .. ' I .J ( .. . f• 1··(., \ ,1. ' •. -~ '' I : . \ ' . \ \ I \ :... - . .~- I \ ( .. I :-~I { ✓ I r. ) .... ( • I .~~-·' /. t I I ' ,., I ..,, I I l(t ' [ ._ t.. ' ' 1 ,i / \ ·' I \ 'I ."\. I ,{. I I ~. \. . , • , ' . ~ ) I .... ·1· f~ I II_ ) '• ~I l ., r ' lo.• I l .: .). .. \ i I I '-'· tt'✓~ ,' .. / ~ ' ,: '--..:... I ) . ., �Form 1!!3. rJIB vNrON PACIFIC COAL co. Mine No. ........................................ . VN 1, OF PBNSONAL INJURY. RbP . . .1 person 111Jured, {lame 01 u 1tion, occ ,,. .d t oatc of AccI en ~ (~.,. /J /' J.1-.' . /, r a ,,,,t-uAA/ r::-:r- -' --1,( .,/(A_ ~ /J r-r · ,? ]Z; -V--rAfr , / _.. -✓- ,,,,_v-e, <,a.A...[ _ Loc tion, . .(,Vl,,(A,,,,A/ • 0 11 ;11iured III nt111r , state where, f/110t 'J f{ame of Mine Supt. r~ ' Age of Person injured, Sup'ts No ................ .... _ .fr • <:7 ....,..,...,.,t~ -) ::> ,.,,.,d •✓- a ~ 190 ..:; ~ Mine No. Time / o ,,? .Ju/,,,fhrw'L. 6 : J rJ . . n,r, Entry No. 1/ Room No. / h d!~ !}- , VI/lat family, if any, HottJ tong in employ, of Co. , ~ ;)_ ~ o n d i t i o n of life or Circumstances, me and address of nearest liuing Relatiue, { ~ Na H . . ..JA was t,e an efficient man, ~ Was he temperate, t11 Where and in whose charge left, Name of Physician called, if any, Name and P. 0. Adress of Witnesses. ~ ~ t -- 17"7/4, Nature and extent of Accident, 3=t:l.-(,..,<.. (AAA_~ ~,L~ £.--u , tv.,,,,,«,,-_ . :CcJ:---:~ ~ , u -hv ~~~~-. I I ,1 . \ .' - . (Signature) r~ Title, ~ if'~ ��....... 1, I • .( • ..t ~ . ,.o:.: ;. : ,. .;. t I' ,,., yo-....1. :l.n t,h-: ., ,; \ •~- ,- -., . .,., ? t , ,J. ' •I • 'l . •• • .t ' .... ., ' . .. ' r, ., T-1, I f~!·~tf ,,')".I. ... ., • ·.; .... • - - . , ' . n. .( t1t·..•l1 1 ~~ ,; • • ' J l •' t.: '{ <:,:. :· •7 i.. ~ ,'i J !_, r r; ~ '. : t. - ! t . ,. .I.,. I·. "' . ·.,. , ' .... .. 'tr, ) . ,,, . ,.... "-: , . ., ' .. 1 'J r ' , J, . . ...' tn i,:" i , .,.. :1t, ? 'J -\, , · . : ; ..~., 4.> ~~ ~ 1,. •;•I ycu •l ( l 11 0 ~1·.1 -L r \t I • .., ( ' ... ' ' - ! '· : . l !~•1 ·I.: l l !J ::"' c~~1.t. ,., I ' ..... 1, •. •••1 .• . ' • ,-:, , ; 1•-- ,T1, .. ':•j J ' ,,., :n· r. .,.. ~ "Y• () J n;:, ~ l 1, t-H.,,:_ •y ~H .:. , 1., !' ,, ·~ j -!'. '· ,. ,, t ., I( •,J· ' L t., ~i ~I .- •, l (, ' ' .,7'• .; ,,. ,:o ' ·d , ~ ,, . ;, Lr,;· f1 .. .. .. . : ; !": , ~- ·n . ..., . ... ... , , ... t. ., { \. • i.11 • 0 • i . ,,(, .. .r , ...,' .. I . .. ·; :ri t> :1: .· •:!? ·;:. , , c• ,{, ,·.1, ,;., . I i: 'I 1 • ;, n . . t '. 1 ... ) · J -~. ., .r ., j J l ,}1 ·· t. I Lt, ~- ; "l , ·-~ • J - • , :, • ·.:.·u c . ;1+J • I l • �. , .' ,. , Knnr -J"uror o '.) II I \ By F.c"i.w. Knar-Ju·('or. Q. Tl1o-ee ,1 ould -,1 0 1-; lHrvo b , o 'I a~:y r,·1.ac e for •t , him t,o s t;:.Lr•cl 1.-:1 1 n a •1 r Rl t rrn ff-~et J.one;? A. Uot to Btn. ;cl in snfnty o o.. Did you SflY +, :1.c ~irorJ ':'m...., :w t 1)1unb 7.., A. It 171;:.;_; lo:1P i.nL t.O'\'Hl:i:'<l t 1 o i\i (;riJ.e r 1 Oo q. D1cl nc :r.7.~l~o any :i:'r:h:.n •tr-; a1)out kn ocJt i.Jv:.· t i'1n.,.:, Y)J'.' 0 1) out? A. not t,o i•,:f 1tn onl e·lL0 o By Joi1n u~ xu o}.1-Ju:.ror o . .. rcn i::;on :,. .0~.r ,. 1.-. ..-.i·, .' 1· (">,.., I'>,,. +:--_ i ?, Qo Do you Knorr o.ny O t nm ,..: 0 •1.... -_L· ro·~1 1) - u.. 1 A. Tho-re a ·e .. ovP-r~.1 t n lnr_ s it c ould ho u ser,._ for o 3oue~~ir 1e s t l'J.0y U80 then: to shut -tl1e C ,.,r C~OOI'S o Q. 1,'Jl.:, 1. i r-; tho dist r-u1co fr"Jn t. i1.c-; ra:'i.l t o t :r10 t rop? A. I should jur'i.r; o .Lt woul ci b e e. f oot a dd a ha lfo Q. T110 <'l.i_st-=-1.,_c('} ii1as di vid.ed nb out. o qual? A. YP-s. Q. Do you thi.ck t hnt roclt, t n at i t would j1a~re b n en T)O f:; s:i.hl0 for i t to J1:- vc fallen XI unl e ss i t h.ad been t s.rnperod wi.th? A. It is ~oo:·· sibln fo1? j_t to fal 1 1Jut I t11in1c :lt uculcl tc1l\'.e 1 i t t l e time for 1 t to cUscharge the J)ost. t 1 0 P . ] · . nL '' :. e r v 1 • • 1" ... ... r" • ... By F.cl-g. Ke:-•1•-Ju.ror" Q. Di1. you oxn.1 :~nc t ho 11r o~1 to s (~e i f t.i1ere wa s any i ml'):-!~ essiog} ? A. I ex:m. lin::d nr d cou1 r1 no t ,10 pro!) and found marlts on t .!.1.0 l')ost, but tl1e prop b •'3entu~ed J ~1 ".'P-Viously as a ladder to t,ry rais 0 t h e rock up. I e,011 whet her it \ilo.s t ne rnarlc o:f any tool I" . 0 I .....-- I ' I~ \ �his o~th deposes and says: John JJykCS b0inc· fiDst dulY suorn on u }':1:ie Foroman nt uo. 7 ? Q. You o:.·e !~ . Yns. 1 · ~ rou ,,·Pt I\ ,., ,. C'll ( l (,. l .. ,J uan aettinc k ille d? worn.. about, this l;o \.b'c. t .fi.ft,Pel1·--r:1int1tOS to c lev_~n o ? 1'.o J,. OU'.) • 1· ~ t J1c, ac.,..i..:i,:.nt 118:r nen . t ··,10 (~'L 'Lv •• -0. ,·rJ1.cl'<, , l! ., ... • .,. , . - f' r1 !··,... t ton ,. I RJ"'OU , r. j1.}.(1r-· n f\b o ,;_ i, llaL. :.l~, i ,... ? A. ~ ·-· ~ :;.. .,. ;~,=.t cr.t~.,-:i t~r,t norn n~ 1 C> V 0 o. rns you .L-• :., - • , •• J • .. t ·, ~.., .,,.,. b (; f o:r c ? 17 -;r, you u1 ,1~,, .,, ri, ,n r~oi-- 11.i nL bc:forc. .J. J. ~ . ·'· 11 ·. ,. room TTJ~n you was Diel you oxr-J •.L,10 l, ,. u • ·1 to ",.c e if A. "J 11. O • nwn 9· J:.. Q i n tno~e? t nA ~ uer2 Hr:.y cut s a..:ct. on outJr:nc e P.: I <-!x--:nined it on t~1fe t he i:'G r:rc ,_'t'-l any bro =ks in it o 8 1 t he inst~c to~ ' Q. Dirl you :f i jYl any o A. Mo. Q. I n your 011inio11 you • t ·t tnou:_ ,1_1, 1 : XRl iinf:cl t }Jc rocloe r:t num 1n1· A. I 1 J never sm1 no c )uince p; t A.J••_,. Q. Though t A• Ye s • ..,,.. sa.. c>n for .... tirne? ~ .!- ., • r , l e 0~")1 ~ f of t imes for •• , 1 o·. weeks and i!o. u I it \'IaS cnfe onoueb.o - 1 . .• .l • t . . ,,. ~,,. i·,, J.•ng ')" Hovr long h acl t ]1.is man been u or 1-:.. ng 1n r,!1:1.. on ~·- Y rL~ 2: I coulc l not ho Q l: b A 9onitivo about 1:,112.t. I ~nould JUdi !'O a yea r aEc'I. a n·t.rl 0v:;r ]1avn o··~c ·tn ion to dJ.{~ roe1< o.m:n? Yes, he was uort i nc tvo nnets RCO tomorrow on t ho switch di ggi ng clorm loose roc lto Q' At t h e Bai,,e 111aco·? A. Ab out 40 ft . :r':r~om t11e-c•o o Q. Tell the ju-cy ·,11 ~, cause of t !1l\ a cairlcnt. . ,. A. I don I t k now of a ny i.,oai:.rnn t 11.::i. r, I c ould G l vo •~flflm as the c ause ot t:n.o nocidont . It f;0e1•:1: very str::i.n: ·o t o 1110 t hnt roc1:: Yr ou ln. fall and discharge th~t pro1) vrl thout c ivtnc gorne rrarn ing t o enable them to got awRy. OrC..i:a"M'4:ly 'tJ1:·,t rock t i ves a g oocl deal of 1i1arn Q. Hov, fnr is i t? A. Ve::ry closo to 12,700 f t,. Q. Don I t you thin}\. t i1 8 a:i ·c --!ouJ 'l qa•rF.J so, e nff P-c t on 1\he ro0k beine so f !,r in from t..tlc ot11n:c:-,? A. Yes , t nc air nnf:., fJOhlG of:: ·ect en it, not, eo 1 ·un:r1 n 8 as t he Hmoke. Q. Diel ycu hn 10 any t ir-1b:_1:-:>nen i n thcf;' O t ;1>1.t, 1:iornin[~? A. Yes, I fXn, t Fl t imb'11.'r.1~:rr in t no n tl1r,.t r1o~eni ng , but t J1ey exRrrtined t ,1n rocL t i'-0. r.lr y hcfo:i." o . I tl •i.rl not ::moat t o h i n abot:.t t hat rock t hnt riornint:-;. I c1icl not S ~! C any O:-.nrer V!e o.].VIRY f:l t el l t he ariv1 ers ':'' honcvcr t t.Ey seo any pJ.&ce trJ ►.t i s d1tHJP,rous to t,ell the ~inbo:rn1~n and b.avo t i:.c1-1 re1)a:lr it, nP-1- not to t;o u 11l•.e1~ until i t 1 1 0 1.s r epnired. • Q. You ,1ar 11cd_ t11e drivers to do t h at? A. Yes. Q. Did Mike eve~r_ s~1e~l( to you a out t,}1:;..t place? A. No .. The rocJ\. t J1:-a·,~ no had tr.ken dov111 trio v.reeks bofore t,hat, he had !'!.)~~en t~},t~- abe~t .th~t ! so rre took tJ:\is othe:r roclr. do,rm., The - Oul.. I Ha. ,~ 0 .Y~a:• i ne of 1 s not, as thick as tlla t, it was more open, set a.rray 1rom t ;1e top a good deal. Ry J ohn 1:!axnell-Juror . Q. Di(l t.hi~, d.rivn1.. 11.ave any o ~casion to ;• t h t .p,., .· , , a J. ei.r w .Ltn .rns mule? mr:y be m01 , 0 c!:lrs onm~~e ~han fl. trrp of loads on t 11e sv.ri tch. There his horse·· aro~nd to h e n?lr ?nd of' tne swi tch, so , ·an.en he turn t •1e ouitch an(l he didook on t ne ~o~d, the :-e::. vre-_.e J,Ju-ee loads on up about OPlJGi tc wheren~~o~ult tlle! • ciom1. He :pull ,ed .his entry ttiP Q. You don, t know .., , . ,_,e 11ree cr=1.rs v1En•c~ A. Uo, I don't T:11.et .11 . ?r t ne d..-rive r had tied nis Pt\lle? tie• • Jle an1.li1a1 \78.~ [entle' and tl1~:rr:. • to v 111ns no occR:=JJ_on Q. A. Sometimes t11 ore 1 8 \ I . . LO 0 By \'Trn. \'Till iams-Jui,:o~- Q. Hou i'~r '"'a . . . t l A . I 'lid .:> 1e llorse run in? no seo t he horno until t af'tAr he was taker1, OU t o �J. li. #2 Q. HoTT 1O:1L· .rlo ..you thinlc t he r ocl<". 1 ay on h im? A. Abc:ut tour rilinu.tos. Not any moro • .Aftrir CJ1:-,,~..l i.0 cm•1.e r unni . my room, I rras u p t : hin instrlo OJ':' four ninut0s o ng Q. Do ?OU knou nhet l10]:• tl1:-.t prop HBfJ pv.t U!) 'ti~ht? A. I cnoulrl tiD.~r so. Ti 0 11t r;~10U £)!.t, that no hor s e coul ·'. PUll i ~. You ,ion ' t thinK t j_1~ iw:cso I s chain couJ.i. en t ch. on it and --: t rto • • 1)Ul l it A. ?To, GU,o I ao not t hi n]~ it :7GU1d .. :_:r_i'ieE t l1.c t :Lr1b (JT'i1()ll ·1·iu ... .. . t ~1 ' i''(' ·it 1· c • t .) P. · (' to r •t•".1t".J...,y17 • , •• .1.,,.) J.. t rlorm ? .. - _,' - ~ .J ,~ - J ~ I. ' . 0 �. cl • r. . .i"':-•1.J ? ,Tl: . . : • { }':' • • I \ 0 l• . ,. • • ... ,; .. ' • ').; · :•. ·,j l • ,..- 1 -.' • • ti) '..' , .. 1; " ? l : ,t, -: i : ! ~ • . --: -i . ,, ,;__... ? 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(;, .-1.•c.n~: \' . n. Y<;n , 1..-~ r,c,·~ , • l' o I I '>, ;t ~ ·,·:-1:, t-,, . .-,. ~nvo ? ,1n v n h ,,.,,, 1:11 , ,~ ,1:-• ·- '·" ' ' t :cc;: i, 0 ,;· J\ ; J.:t, �) ) ) .. ". r..11> • C j • 1• • I o. • "\ .., , : 1 , . l. :-r Fj o {, j i. :, ,.: -::Lv r t,oo? 1• tI --••i 1 t. • ' • . •• 1• o\.:n ? it,? !-, r.·.r ., I :-,r Cl 1.t, ;_to :R'!T ,Jo1"1 J"!~C~m1J.-:- J hJ."c·,~o ~- n--, ·ro- • ·,:no" 1r, ,• , t t,:, •. 'lI'i..v.n-- .,. ,· r~ot:1r'. 1-:-J-1 • l! t 1··• t, "('C ' ; i'. i'r;ll? ;:, . ;_t)•.·n . I 1·e,,, ,:, :;· ·en ~rr .1 r.,'.'"'l 111 f, . I• • r (. • \ ; ~~ (l: ~ ." ,·1 ' : • ' L i', ' · • L" ( J ! • t rv (:,) ~o;ir .,.. o r;,. You :: . t 1, r-; t ~c ? A. I 'i,'l.·.• j~.1t r:: • t ~~· m~t . n_,e . ·1•· r~,,·J •J (' L·,,0. V ~•J • -.... • A. H·· 11 i'l\THS t r;-; i- •:• , , ,:-rm· l i'!,::l. t! ,· j~·, ',/GU '{ ·_; · ,•1,i. ! ~ t,r> P.y Jor1n " n::rmll- Ju-i.-•o~'.. . o. Dt·l Jl() llt:•V{' to l)n "'G 1l~'(' ; \',' · \';:."' t• ·i, ,1,ro-l, roc.1· ·- :·,:; ? A. \..ell , not r·xr: ~tly. E,J ~aulrt hr vr. 1 .~ r;::l c c: --·:· ~n·,·n (•J.nc .. Q. He, 1ltrl n ot N\VO to [C t •ITOH;. !l i;Jlff'' C ? A. Ynn, s :t:1?. ny r,·_,;! . K:--~:-- JU"C'Ol". ri . n1..,1. t un \n!';-;t,..,.1 4. you t,o r--. ·,y j°'..C rn s ·i.." t'ivtr.£:. h -·t \!1~0P t,~·.-o i',.rt.i.nss? 1 A. Yr: n , ; ;ir. ~. H., ·~ i. ·t '1· r, A. 1~1:·: , i".,lx- . ~1nvo ocn~.r,ion tc br) on t i1:- +. er.'1. of t .i1<~ • ,1t tch? Cr) ~lr-tf; i)UlJ.in_~ Ol'l!)ty c~.l"G. t;~)i ·1:.: h r. ck ~.1 it n ·niH l 'iUJ.o? A. Y~o, .1e ''lt\.F.: c.;o i nL h ,cl<'. -r:li,;1_ :11e n u.l o . Q. • 'J!t,\~ ;c:r-: ~. -;f} I'.l\ll e r:w ... t, flO RCcirJ.1:irt, ! )!)_p p:)rH~d? A. Tne r,ul fll rra.s about 15 ft. nilo::\cl of: i1ir,1 . Q. ~":: F; 1."} B!r ,Tohr. l~! ;Xi'lell- Juror . r.. You uh~"-'n t ho y ........ Do vLno,.., k jur.;t . ..., • • "')lnc' ~• 1'nll?" • ., Q. ~ 1 :.• . . .., , <• l,-. , • -- • ,. . A. 1 .. ~ \.ncu .ho\'1 ,,1iy fcot tt, 1.s f1•0, .1 ~.Pn i ·.11 J.r J.'on " ,... .. ,~o ' - i:ir. I nov r; ·~ n nanur~d. I couJ.(l not, i1vt,,.~ t \'• <:- . 1011 t. fl<: ~- 'ouir1. ,1r, have any Ol~casion to COLO ~s .......1:r> ::._. ' · '-• _r ~J.st:1nco . A. Yr,f3, tir . H.a: wou1,1. - ' ' t!)"li, roc1-:: fAJ.1 ? 1 �1 r 'i , ct. t in . ' "', I • ntrJ 1 r C, 'I -·1 . .. - 0 ,r " r l'r1 . 1.,•,, ..... t <, • J. 't.n t : y • h<, c . ,. .. "'• ..1•,1 .r,.J in ~ .:er, L., .J 11 , l l ..i . ·1 1i r. ,.. • ') 1' 1· ._;~ . ._ nt.:.o i' ' C t-. I I ,., _ l. Oo i r • I • ; J ' (; 0 . . ·~ . ·.,_ /\ :s' ; ·- " ,-. ' .. . ·~ '/' '~ ~ 1 • J .'*.·' ' -t ~ .. . �1''onn 123. UNI ON PACIFIC COAL CO. ·rH~ ~ - - Mine No. ••••••••••••••••••••·•················•• ,r OT•' Pb'RSON.AL INJURY. J? /1'/ •OJ\ )W ~ L e .Fforson injured, ~ /lar.li! OJ. 0ci1/l'a(/OII, 8up'ts No ........................ ~ / • ,FAccident,/i ~ ont,· 01 "'IA , tocntfo11, • . l114L./ ·~~ • riurod in l,11111, s,tate wl'iere, .:2 • C 1/ IIOt II~ 11.,,,, of /Jine Supt Ago of Person 111JUI ed, What family, if any, _ ~---- _ • ---v 7 / o ~ /?u.~-<,,,;C. , ~ Time Mine No. 7 ------------ X- ..:[" __ 190 6. d::,l- J" o/--, How Jong in employ, of Oo.' ~ d:1Y?"' Name and address of nearest liuing Relatiue, - f?.._~ "( ~ Nnme of Mine Forman, . Marri~i~;le ~ ~ -~ - 4 Oondition of_;:!fe or Oiroumstanoes, '-1 ~C::. ~?, · ~ 'yf~ ~e~ate, 0 , Was he an efficient man, l'//lere and in whose charge left, Name of Physician called, if any, ./1..-<) (/...7'~ ..___ ~ ¥2 __d 0 -- - Name and P. O. Adress of Witnesses. ti,.•1.n'it: ·~.th li, .'. inc t,r. .' . r..r. r.~ 1/ature and extent of Accident, IJ ,-..,,_,t.e.._ / ~ .c;I ~ ~ .J-.,.,,,_ ~ -, ~ v - ;J , l \J .Af.../ . f-e,. ~-A' °t- ~ 1 ~ / t- " J'\/ ~ ~ �, 1 -- \.• ,, I('I ', \ ,~ I I . I ' ~--~... ' ' - . 'I,' .. ' \ '. \ I ,, i , I ,. t .., I ' '· r 1 • • i, .: I \:l° ' I : i '. '' ' ./ ,.! \ '\.I t\i I • (, l-- I II • \ I>. rY~ . .· ., . I • ' I\ ,.,., \' •i ._) \\t: • i \ ·~\ J ·.,} \ I . , I •i \ I i' i( ;J.( l ., ' 1\\ ' [,·, . -~ - .... {\. \ t } ] .i '; ,·.•. \. '• . ,, I. ' \\ I , ,\... • V • I • •·· 1 \ ... \ . ..." \ ....-,J l. \ • ,r .• •..,.,,,.( . ;.. i ~ ...\•. . • X,J I ., II .I, - I \ . \ •. ) -..., \.J;--\ } •' \ 11 1' .) \ .,/ ·, I' r • , { \ ~ ., I S· I • (j • " I ; - -~. ' ( , ' ; ..• .,. -..I.]'.' l "'.. ~ I . ·, , ' '•::.... , ' '-_ ', . J I . J, ·\I ,.,.. - ., 1. ·1 •! ,'\ i :.!~' I "' \....., �...1 pACIFIC COAL CO. fH~ oN[0 •'I 1 Mine No.········•···· .. ···· ..................... - - - -- R1' OF pHRSON.ilL INJURY. ~ 8up'ts No ................ pb'f'O ,f parson injured, ~~ --?'/_ ~ ~ ~~~~J~ o,c11Patio11, ~ 190 6- - Time of AcC''den,t --1 / d ~-~ ~ - SL- -...._ ....4/- {?'J ) oate _Ar~ Mine No / E11 t N • c.z., / ation, /J • ry o. ---==-.. Room No. Loe .. ,red in Mini', state where, ~~ /Q..e...- ~ ___.,.,....__..,, ___ ·--:--# f,p - _ If 11ol //l)l . - ~: • - - - - ~ ~r Mi11e Supt. Name 01 . . Age of person '.111ured, / Name of Mine Forman ~ u _ ' , .,, .l"-0--<::'.~ ~--'--<. Married ingle ~ Whal family, if any, ./J tong in employ, of Co.' ~ . . RI . H010 d address of nearest 1wmg e at, e, Name an Was he an efficient man, ~ Whereand in whose charge left, .. Condition of Life or Circumstances, -:::J.- , d ~~ ~ _ _o - -- ~ Was he temperate, . _ ......,- .,.~ cjfE ~ ~~ /lame of Physician called, if any, ~ , / ..:;t'i.,4~~ Name and p, O. Adress of Witnesses. flature and extent of Accident, --~ , ). .,I\,. ./ (Signature) Oqte - ~ o f....::;/~~ 1:~ , '---- '--------..._ L,.r n - _ ;-:--r ----.. �Mine No .......................~ 8up'ts No.................................... .!},/,, ~- ~~ , person i11j11red, fiallle o, >///z,,-J~ O)A 11/i(l(iOII, . .I' - 0cc . ccident, J r /-t.,.-,11~ I j 190 6- Time tZXnd f :.3 0 ?/, ??i _ ontc ~! A t,d Mt:::;~J,,-o , ?17r _ Mine No. 7 Entry No. {:__. Room No. ._JJ ,-/. Loea11011, . . ed in Mine, state where, ti If not ,,uar d ol:'__f~~ (Aine Supt. lt,e_,,~v Name of Mine Forman, {lame 01 . d (/ .:? 3 .1/'i'--t/ • .1 person i111ure ' • • Single Age 01 . What ramilY, if any, u/ong in employ, of Co.' ~ & ~ Condition of Life or Circumstances Hol nd address of nearest liuing Rel-e.titJe, ~ ~ di IJ/J /7l ' / ~ flame a was he an efficient man, t1d in whose charge left, Where a . 1 Physiaian called, if any, 11ame 0~ ~ 1 -- . oz-- , J /'JJ ~ '-~ • t? ~ ~ (X-- . Was he temperate, J~~ fv__u_,,..l, 's ~ /-;'I ' . -' - , -1(I , /lame and p, o. Adress of Witnesses. Jjij./ I bate 1Jr.~ ~ - ~~ ' I ~ _ ~ ' • �ny \·p . Dt(f,: t; on- Jl~!.°"J:.' . o. \ '1 ~'\ t 1-~tnr~ of. 1;or; Lt;i on ,., ·c C' J.y t. ~· :i.n? A. c •'~" I ,,.-,:"1; h t rn , ·~. ,, J ;n ·.; I i; 1 " i ., -;:, e P. t, o·.:~.P<l t, 'A r oc, 1, . His 1 fr:':11 1in1.:; cov e ,·.:cl. I GGl., 1. •1 . ·: ~~ • i • i. ·.r _ 'Y , :r 11 i:O!' t, n· r o cl~. ~. Jlo y o u t hl.nk t,,:· 1. t.. tr, ;, •,1 ,1· : v1 ·;. -· ,rn: ,n clocm " . ·•l , ; o ' ; , r- ,. nJ.1-11 A. I - tllt:11t t n11 ro~ l·. }:·i.11,~r'. 1-:i r. ··1.; f; QCl"l.. t t h:lt h:i.m. i ,1.on ' t 1.,hinl\. ~ ~J J.t 01'..Ct,z!O ·'ri:1. 1~ !.1., , t, '1:l , C!. You •l'\.i i. 1~0~-. n -e o:.:ry c· ..t. f, 0 1: ·,,}."". . i ;,1E, r:."·, ·,;.t :·! i.:1 ,: ,1 ~''i.'t 1 A. He i1~rl n rn11n.·1.1i r. (~r, f,·conwl n .i.·:: :0:1.(l , rn~~ :10 -1~ +,c, n 0 11., 1, t,u nu.eb . Tl1<·1 r;!.in ·ep:• r.:ro1·. 11 n. lL',;·:i.n . r,. \ 1!:A.t ttno \iH,j t ~1.~ t ·i. 11 t, . ~} 1 ::;,•··n tn ': .\. \..o J.J. , I :;hou·.(: J1..::J._ c :1} vi,·:; ,:i.: o c,·,, :·, "i. ! ' U!V-~t.y ~. -, ,.... j 1:.G e r.. 0 for l.'O • .\.'1 TITt f, (,Oi.'l . -~o~.'n ui.l~: c 1:.T' '; :CCi' l :1 :; · ' ;~ti. i; "i.'P "Ln t r, r Jri1 ir1[ o .)t , �w ... \ , . •[:j ·~; . ..·, .' , ., - ,, - ., It . .. • •r • .. .., ~ ... ! ! -, # •. •1-:: ... '\) , ,.·t'lr, ~ 0 r. . • ( • • • .. ,,, ... -...:'I. I ., .. -,· · • .., , - ' .. ..:r •• -.· i , 0 ., - . .. ,. r , .., (• .• ' \ }· ~-- • , . • ,, ,. . . fl[ ': . . ::.1 • 'i r ,..,: ..t :,.1 .. y ~:; '''j • .. , .. l~; ·, .1"· "d·' r,r: ., 1 ' L ·'~·U •1 l 'I . .. i" •l ·j·. :O ._,: "(r\·.:-r1 1~ 1 •( ·r~· ':)'"(; . 0: ..., , \ ... ... •"'."t;.. n•i.~ : fl! ..I ; .- ' ,., n . -,~ ,,.. .., .. : .. . J, A. ' '"j : • . I . ,, ..... 1 , 1(ii1 . :n,, i-_l. t ~. ~ • ..-:·~ •'! ; ~ ,.., 1 . .• ' ; . ,... r -..,• ..• ! \,,,,: , .. •.• 0 • • •;: .. r:. 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":''Jl t 1 ') ,. • ' \! _, • l r ·:,: Hn :1·.:1;.. _,• ( ,-::, '? i.• 'l",·', i. \ ,\ I ' r;_,~"O Jr: nT~!~J -: ..,.• '·I I :;1 e, .·,; •' r; . ...- .,i:): ~P '\ • ,-~, {I .. . ll"i. 1. i·,. ,-1 t1 ,·!:t -·~1~ ·t~Ti'!~~ . . ~.: ,to ·;,~ !.'.1·i ·i, , :· ; ,..~ 0·, •"; >\ . r.,_l!~c -~ ;!rl .() t,o:_:P"(.. :l,~l"' t".!Ctllr-\_ .. :c., ~~ l t_~1; 1~. :n i;u t.•~<~ J'CJ;{f, 0 11-i·.1·1'" rl:\---t t·c) t, t ·\ t :· n :~r· :. L; ·rt'·' t "': r~ 1 i,. , • f i.)_ i. �I 19 ('5. . ; ! H I " - '' U t1 ~ -. in 1 1no " ,. o 7 . 1 , C t ' C C J: 1- l v 1 , C ·t d '1.t h r.. i lit~r:_ to 11· :__:l t ~~ t ' ,.4u_,_..= ";_ '"4n-1-r .•....-tn,,· = -~ t "_-11·.,. ,.. 1s,, 1I'lO o Tr . , • t 13 t"'1. a~n"' w,, o ., h ...........~--;~ju;l "" .,.,,.,_ w, es c upe d Of : ' v,r"h • she :fv.te, r c •.rc-,1:: ,;..lk~,1 C.< .,n t o " ~ n ,:t r oom t!· r c,wh 1,!•" d c.rkne s s c.nG. su_"!lllonl :: ..•:Janeae Ag e n t • 0 \ �R .. ~.-t, to ( f '.., ro '( l,. (:',\I(_.•nt· ' t J. _1): vi d • V • •J • 1· 111? ·c,t C,, C. f . :r ' {,!lE; '...' o f..ft~ r t· e ~ant i mony of C • Ge v,,_ · '-' ·'-v1·J •, V r."-' '.f . .·) . 1 /, .;. •_.._ ~ - .. ' t.o •• ,J.<..::{ • • • • (.,-, •; l l i .,,.,.,,.. - - 'w'.•~: L...-: • uf -·._ro • Co r oner. \ .. ' :e;• n .-V. V, ..., 1 0 '-• " '-' C ·i J. U. �237:,~ ~ p ,\CIFIC COAL CO. tir;fO• 111t -- - Mine No. OF p&RSONAL INJURY. Jllil'oR'f 8up'ts No. ········. ··••·••············-·· pl,rson injured, ~.Jf~ f/tlr,;•• O~ ti.•' fAccidcnt, OJt,· ~~ /~ {t~ 011 Li1c,1ti •. ~ I .3 I o,,, ,,. ,t:011, 11 ..... / ··········•.........."C? .A,/"h,1,,...........<--,...q , v, 190 ..j- T ' - _ Mine No. din f,finc, st . tc wher , Time 1 tJ/iJtinJure u. - ~ ?., .;l. tJ ~ Entry No.Jjr,v t ~R69m Ntt. rt,U___ lw . .J-/ ' I CJ. Mine Supt. o( - / ~ · i'ame o1 .• d r) ,...., ~ if person ,n;ure , ~ 1 (I /1...4.. Agtot c.amily, if any, ,,,,a ~ _j_ ' gin employ, of Go., ~ Vl-U. ~ Oo1J dition _0f Life or Circumstances, Hotrl 1on d address of ncarest /'rutng , ReI at,ue, • ✓-~ ~ J /AA~, 1~ fl / ,' A'amean l"as he an efficient man' /.A_ ' and in whose charge left, 11here • if Physician called, if any, ,~ ']~ ~ ---- ~w,{, he temperate, ,1.l__• . rL . . _ ,i,..._r'7· ✓,,,,,-= Name o t(J l p o Adress of Witnesses. ·"'\1 ,O tf ". f/ams a(ld • • •t :rr, I 11-.;r oticc117 tf 7 fvd rf ~ - Nature and extent of Accident, ~~ 1-.id debth i\ Entr; l't t rin~o, lontol, ► (Signaturel ~ 7 ~¥, - U'Title, (.~ ' - .C. . . . : : ; - ~ - ��EormH JJr.·t•vr•1r l; r, "i. r._ f.l ;•,., t f' I • y 0 :i T-n: ·i.1;.~y :;uorn on Y' )11. . 1r 1.' .,.,. J,', l --.• f'>,J ,.). ' 4 L t •1-•L ro Jvl"l ..-, '°/ ..,.0 ,:,,:- t;,L· i n A. Yf'r: . r, •....., r'\ . ,,4 ,.. nv • l • O u0 0:-1.t,n '<) •::.>n., u. 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Ahln tt r0•.~1:- nr:(! • l:i 1 I l r J i.c'vo . -,1:r, t r.r · &,AJil :). .; I 1 1, ok" <'. ::>round , r~' r:~. -~ ;_,;_ rnt t. .-;f!O 1~ •!t' 1 -; ~,n ~~ , I ·r•1 n1. I i.n1nJc I \-: r. r-; t- ~-~~-r- n. 11nw~ of' J;n,_•r-r;!-,; . (1 ::.-. . Pr;,·•, r;<; :1:, ·, .,_.. ,,i , Yor;.) T!l ... i-, c0nl tt011 1 t CC!-'t-1 ti1R.t ::ay 1 v ... ,_~ y of t, nn . '.Pn: t·~ 1 1:,.,:~ ,.., ~' "'.: :·).'l-: n·, ,, .. ·r-i.;:c~ . I rr-:· t -~hL:: · nL0ut t t r:l JOUt l.'i ••, 't.r;Ol! ili nu~·,".!f.: h'::i'or•o . T1:t; i l :~•.;(; ~···•nj• ,.;_ r .1.:'i. 1:f . It, r~ict n ot ~.;nm ! r,:; t i' -Lt •-:ns ·:u,._a;::LnL --it :., 1 1 . ~. You ,·1 i ,1 not <! .. r-1 t n n 1 t, nt n11? You. ·0 11' t }·-,o·.:- ,.. o :~;t ...,, i. t ·::r.r; ] O O H() ? A. I :r.c; r:c•t. ov •• tr1r~ ·c rt. rill , hit L·,; ..;_ ir1. ""!C~· 1.coJ~ ·~o ~:r, to · H. J.oos0 . hFP-i Mn. oul r~ .l:-l.Vi; riOilf) S0,'0-i'.l1i.· • ~;o it . ].t, rrr·u.f~t !lr~rp J.ooknrl :=;n/f~ to 1 80!':0 i'.'O~J,: i. t,h 11im. 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YoG , I t 11ink t,nn. t iu 1.n ~n t ,1.0nn :i. t. I+, \H~G ·lor-;e in a.~ i !:gt::int. (: . 11~:l t llP- rcof b nen ~;·orJ-:LlL a 11y bnfor0 tnrt t? A. It Z!'"\S juut :lf.l (11!.i.C -t 8,.-, it Go1;J_rl i)C . Junt cone of' r. rn;rl_r:.en 1:. Just [aVe fi. 1,Uf',t He ]1i\ 11 been v n .e:r Y::8 , n l •f!'V y ,.r,,. J•. , 0 , ... ,., R_~1 •: '0 17.rl fj ,l_O CP."1 "(} 0 0: H:.+,i.ou~; nhout, h"Lz c c.:~J.? C" l • l[IL 11 r ""'., o·~ • ·-:,,, c1u 1·_,:; ,.,.1.lJ o ,, ., ,,0fu ~-· . ', . . l"'.r:~ <.o-:"n ;;i10. er~ n aJ.l i1; n.-~ "in·Jtrtnt, . ~- Hor, J.Ol\(i nn.vc you 1,-}ntl .!( J.•~ i_. ,r• ·1:L1~! ' h i.11.? Ao T•7o or tnrr::n r-10n i, ·1,: A. J-1.1) 1 0 1 - .. 0 �• Q (: C LH, n 1, 11 C l, ,,,:t in .r~OOl:, ~3, i.;o ·r1 c • nib (').!.,..' . t . .' 1 ~• . l~ r•,1·r .. . ...! ' i--~ : ..jf) l 1:0 '.l't (, 0 I I ~ l, ' : • (, o C.i.(JC!r / !.. ..., ,. G 10 ' ~ne <'f t 1!\;) ', J111.• on • i-' ,..,:cc.·. 1 ,:> t i l p lt 05, 1 . ,) I ·'"! j_ f J i C: '..:!Or:·.1 .(:• . > 11: J• . l L. u. ., ., . 1 . •. I . i, . (J :t' - i. ,. �... ,. ... •' ,3 -/1·/~ I ,:/ I ~· ... • .I , . l ,.I I<- ; I I ..} ,.. ·' .--.: .,, I,' ,./ I I (.. ,... J , ,( / · - ' L... ; ; - .. I ( ..;,• I .r J I . J , ... _. • ., ' . ·, " . •I ;; ! ,· I . I, I l . .I - , .. I ~ I ' •• .... .; 'I • / _,:J ... , .., I I. . • • ,. . .,;· l,.... .. , , ... i ' .... , ' I• ·.,.r - .... . ( . ,,,. I• ~ . .'.... . i( C ,{J .• v·..,,, , I,• ' ; ·, ·"1.. . . ,',J • ....., ·- ~ I �• t1N I •JP 2:1s : l•'onn l:!3. roi'l PACTFIC COAL co. Mine No. ................ ............ .. OF pERSONAL INJURY. l ·f'ONf ~• l 8up'ts No ........ ..... ..... h_ . ~ _ .-,tP•"'"i11jured, 1 )(CIIP!ltiOfl, 1 ,,. of Accident, o,u tioll, /r,1c/l 11;~ I ~ . I ' , 1:" vr~~~ -7 -;;- Litn . ·ured in Min,·, state taere, V ,1eot w ~.,of ;li11e S11pt. ,; person m1ured, Agro, . (I J.t... £ t;jkj,_....-,-,- ~ '1 Time ~ t / f - /#:JrJ me o. / (J Entry No. I J7. Nameof Mine Forma/1, M •d ame Of. .I· ,I ,, v .-v>-t., ~ /,~ ,/ _ .. ,,_ r,,s be ... I ( ,· I man, CUI en;oient '.II' ttere and in whose charge left, tame of Physician called, if any, ~~ (/4.A,~ t?, /'J,. Room No. J'J d,,,,!- C q ~ • • family, if any, Hal ,ong in employ, of Oo.' ~ r - 1 j ~ Condition of Life or Oiroumstances and address of nearest liuing Relatiue, ~~. ~ 4J / ~ ' ~ lfhOt ' ' I M' 19N0..::5 - Was h temperate, IL/ ~ Name and P. O. Adress of Witnesses. (Signature) Ty'.IJ..j-- J2 • J/. ~ v' /h_ Title, ( / ~ I • I £~ • �STATEMENTS OF \VITNESSE::;. S'r.ATD'.ENT 011' IliJUlW> llAN ock Sp19ing , ~omina, - pri i 7th, 1905 I, )(organ J(ooa , aaJce this a t a t oment . ·I w8.!' driTing in 5 Ent ry th1a aorn1nai1t'h•• n1ak1na a7 th1r4 tr11J coming ou t between 9 o.nd 8 r oom, I no.. tic•• a 1a, on t he l •• si• would p- Illa• ot entry nd etepped over t o aee if the car, I a euppiag back to the other oi de of c ar my h eal. caught the root an4 lcnock•4 me otr tho trip nnd tho first x/heE:l ran OT e r my l eg cauaing inJu.rlN . \ �rfifi (TN 2:w ll'orm 123. •JON PACIFI C COAL CO. ' Mine No............................../ , , OF PERSONAL INJURY. RHJ'OI• 1 Sup'ts No ... ~. .... a4d- </ ~ C'-11, Entry No. ..:, F:; ~,:; , ~. Room No. of t,1i11e Supt. Name of Mine !!}f N11m8 . • d .,,, 1l \ . Age of person ;,F m1ure , ...___ _ _ _ __ _ • Single ,that family, t1 any, -J --,1Hu, tong in employ, of (Jo.' ~ (Jonditio11 of Life or (Jiroumstances, I ... N:me and address of nearestliuing Relatiue, :?r~ - J~~ ::J. ti 7 ~ i..11 r~ t, •~{ was/Jeaneffioientman, 8 to, Where and in ~/:ose charg~ left, I 11 /lame of Phys101a11 oalled, if any, itt t -, r ~, ~ ~ , a. µ ~ Nme and p, O. Adress of Wi tnesses. ~~ a 1'11 1titq- f-1 »'irR Was hetemperate, 17 -<'/.R~, UA...,,;\ £ !).f,t?""f-~.--f, . I •- - • r7 --- .J * Nature and extent of Accident, ~ tr , , ~~ . ~ ~ cd-vd: J I, IJ- j)__;_ ·vrv (Signature) 1f'tJ0- .cl . ~~ {fle..A.A ....... /l , ~ . , , / ; = - ~J- /: rCZ~-;:.-t e,IM,C/t;<.;,. . (76~~<-- 11 ~ ~~~ ;;,,,,,,CA'£ ~ 7" I?//. ah-i,v ~ ~ ~ J, :Jt ~ Title,~ g~ �S TATE)IEX TS O F \YITX ESSES. STA~Ei".E::T OF I ::JURED PARTY• Roe,. Spr i ngs, Uyo o , Apri l 13, 1905 . • I \·,as mnn i ng a dri l l ing Me.chine in 4 0 Room # 1 .Dip Entry on April 10th. '\'Tas drilling it h ole i n a X cut wobbling a e;ood deal- a nd t ~-:e lit;.Ch ine was \1hil0 the I:a.cJiine Y/as r unni ng I s t c oped do\1n t o look at t ho lfining and my right hand c l ippe d and g ot i n to the 09g waeela t a.king off m y ~ thumb at t h e first jo into ~Si gned) Anton Oblooko • I \ .. �7 Form 1!?3. ,[ON p,\CIFIC COAL CO. ffJ6 { TN . Mine No. .......................... - ,r OF pERSONAL INJURY. R1;1'01~ 8up'ts No ........ .............. ... ~ ~ r ~ ~ C ) /7;[, Room No. I/ t) Entry No. / i/J'r o1 Mine Supt. Ntt/il8 .• .1 Person IIIJUred, Agt o, ·~ t t'.'.amilY, if any, 7'0 • I ~ f/110 ri l -p- - . ~ 6 ~~ . 1~ Nameandaddr~ssofnearestliumg Relatiue, 11l. q Hoiv tong in employ, of Co.' fl w,,heaneffeotelll man, Dip Iii ~ - Where and in whose charge left, 1~11 Name of Physician called, If any, the t I.Chin, llll1ng I Condition of life or Circumstances, _ g z : ~1 ~ - _ ·- - - ~ , ~ ~ V -;re,_ ~ Was he temperate, -~ Jl~ fr:;J.J~vr-y:::_ ~ {I '- NatnB and p, O. Adress of Witnesses. at,op,• •b &nd go,' tn~ ~, ra t Joint, loo,, (Signature) '%_~ -f u:;-T ~- ?"'· �I I ,p0. Adress ~ I • .•11te11t of Accio l t .' , • "" ...... Stat ement of Injurecl Kan . I wu working i n # 1 Dip Sntry yesterda.y e n gaged in lo ading coal in 48 Boom. About 5: 30 P. K. I wu shovell i ng coal into a car When a piece or rook f ell and hit me on the head and s houlder• • I 414 not ••e how large a piece it was as I WQS rendered in• aena ible. 1IIMI aoun•e• t he roof a llhort time b efore and it s ounded solid 1111& • &f'•• His Garat M:1chell1 X · Ma.J"k. Geo. ~. Pryde , Wi tneea to Marke �1,'orm 123. , ·JO~ PACIFIC COAL CO. . l ~ I~ - M1.ne No. •'l' OJ•' pJSRSONAL INJURY. rot, u}4, 1) ~ i~ "' ' ........ / ······························✓ 8up'ts No ......... ...~....... ~ t a .,30 Entry No. / •,,•c011,fine8upt. ~ 4 ,of person injured, ~tfamily, if any, J. Iof_ • ·f'~ Name of Mine Forma.n,. 0/ .M:a:.~r:bw -- - v 3;;7F ot.q Room No. £, . Cg . a Mu t twCr-w Single ~ _... ~ f , r----< . tfong in employ, of Co., ~ Co ndition of life or Circumstances , a11d addr~ss of nearest liuing Relatiue, ~ ~~ ~ , t r 18 V'~ is he a11 efjio1e11t man, IL4. - (7 ----- 1~ "' ,,as he,temperate iere and in whose charge left, : : ; I r v . · ~ ~ & :~ y~ _J. ~ ,,1-: 1 "' eof Physician called, if any, 1 fl. 111 0 ~ tJJ~~ v,.../_ ~ • r~(j-...__,._,_, eand P. O. Adress of Witnesses. (Signature) °':~ ·l..11:1 •. ,m. #~ 7 3 . ~ Tit/e, /,J~ ~ f~' 1 �'fgE UN ,,: , , OF P ERSON A L r 1''orm lJ?3. ION P ACIFIC COAL CO. Mine No. ...................~ I NJURY . NEl'O • 1 8up'ts No............ ...................... I ~ ~_L - ~ _,_,,', O,F Person injured, flame" (/ • - -; ~ ~ o,cupation, o/J •• oate of Acoi~~nt, ./#'l.A r--r..d . , / ✓~ - . 790 j Time Location, I ~ ~ - . - r ~_ Mine No. t? Entry No. If not injured in Afin,•, stale wl,;re, (l - d I c~/ / .7.... Room~ ~ ti No. ~ ;__ /JI flame of fAine Supt. Age of Person injured, What family, if any, How long in employ, of Oo. • 3 ~ Name and address of nearest liuing Relatwe, was t,e an efficient man, Where and in whose charge left, Name of Physician called, if any, Oondition of Life or Oiroumstanoes, ~ 7~ ~ ¾..a.- Was he temperate, ~,;, ~~~ L , ::r17 fl!_ , J':;:::;:..,..,r ~ .- ~~ J~ Name and P. O. Adress of Witnesses. Nature and extent of Aoaiden~ .J ~ __/).L ~7""' ~ ~#=--IA,-t ~ n I J ~ ( Signature) fo;, f a ~ Title, ~ § ~ �STATEMENTS OF \VITNESSES. ·, '·, , ., �Form 123. Mine No. ••••••••••••••••••••············· 8up'ts No. v' ',~ ,/ , . person injured, r.rme 0! 1patiOl1, if Aooide11t, JJ!r O 1 •• ,t' .,!1/ioll, .,.,,. . . 1not 1111ure0 , ---1/.) (I d./44---4.-1'-- ~ r✓~WM ,A - / /.J_g::: +'' • 790 d- Time Mine No. / ~ /~,,-c,1v I , ;,, f,1ine, state w 1e1 e, (I IJi, ,I,.,,! u;ne Supt. .J:t. ~ f j ~ :,1:;,:, ,,,,a n in1ured, if any, • ~ .............................. ..J ~,.i tJ G .\ 0'7/7. _ /V /,,-I· Entry No. 7 ,.,,._ ~ R o&- ,,.., oom No. Name of Mine Forman, • c,1-_v___ a '/ d - ---- ,(Q ~ __,/ M.1trr,a-w Single »f • ~ "Jong ;11 employ, of Co., .c/. / :J.., ~ Oondition 01 Li-Fe or oi·roums tances . J' address of nearest lwmg Relatwe, ~ 7"/4l ~ ~ ~ ,fame and , ~ v ~~ ~ •'was /re all 8»' ,mcient man, • ,~ . 9..4,,,. __ , (h Was he temperate, 01. ff [ i~here and ;11 whose charge_ left, Name of Physician called, if any, ~,, 7 / ~ ~~ -N,,-,;-;, ..1. ~';t-:-J ~ - (/ ·~ . J.J.. ~ ~ '-' ' ;t It;, 11,., a,d P. a. Adress of Witnesses. (Signature) �STATEMENTS OF WITNESSES. �-.T 7 Form 1!?3. PACIFIC COAL co. (JNIOl" - -----F pJSRSONAL INJURY. pl~f'ONT 0 1'ffS 1 MineNo ....................... 8up'ts No.................................... /_/a,c,. -It , , ~ o(._~__._-. u tt occ1111ation,. I !"...!!iZ" 790 .1 ,1 Acc1de11t, ,,Jl--;r •• oatc o, -1/.J I/ ~ Mine No. / /VI • atioll, LoC, . . ·ed in Mine, state w ,ere, . . ,d .1 person IIIJUle ' 0 11ma , c/~ J?~ Time ~ J/: rJ tJ f? (}?!. Entry No. i./ r Room No. C If not ,11;111 //anie of {,tine Supt. . • -~. c(__' 1'314 I/ 1 ,; Person m;urcd, . ~ Family, if any, ~ t Wha . Go ~ /U' H utong ,n employ, of •, ·~ 01 d address of nearest living Relative, AgOOJ I ~ lfamean was he an efficient man, and in whose charge left, Where . ,1 Ptiysician called, if any, Name~ 0 .. Oond1t1on of Life or Circumstances ~ ,LA_ ; (> IZ) 11 ' .C~ --,-r, ~. ~ . .,,..-~ . Was he temperate, ~ .h---t£~ ~ :· ~ 1 ~ f;. 7.. ~ /Qt_ ' ~ . (! t£ • ./'Y-. fJ I m ~ r~. Name and p, o. Adress of Witnesses. Natu~and extent of A c o i d e ~ ~ ,,. ~ ~ ~ ~ JI-/, n . f. I, 1· l (Signature) �STATEMENTS OF WlTl~v,.:,o.uu, I ,. . I ( (,' f:. 1 , .. -- I ~ t . ,.. .. (.I I ' ."' ./'.-~ .. I ✓ • , .. t';t •I ~ l. I l ;,J. I .: I I·.. ! . ." ~l I ., / ....... !/ c'..... .; t I I I .t "" ..... .. I ( ~ ' ..,_/.( ,r.( /, ' �tI-I p1woR 24 Form 123, '6 tJNJON PACIFIC COAL CO. • - - - -r OF PBRSONAL INJURY. ,f person injured, ~~ ..,tJ ;J IJ • ~-- < J ~ ...... CIA - • rAL ~ -~ ✓~ oatc ~f Acc1d~£?:;X...,,___. Jf-. { ' :::;~:;:: ~:~ed, Wltal famtly, if any, I '\:> - . 190 6 ~1~ •~ - Mme No. . ,iured in Mine, statG where, (I I/ not tn, <><[;t/ Time / ,t/ () 9~. Entry No. 1/.:J- Room No. CJ f :;< m~ Name Mine::.::~~;;,.,,$.. &~ of , . 4 Holli long in employ, of Oo.' . 5 i ! A - ~ 00ndition of Life or Oireumstanaes name and addr~ss of nearest liuing Relatiue, ~ ~ ~ !.'as he an effiotent man, , ~ . _Cj,,f_ A "' 11 vvas ·he temperate, ( f :hrr-'. 11/ # .:.Le....,L__ - / ?::--vz ' ~ - v - l , fll__. _,./. '-r- / ~~ f2. J},,L. (;2_,_;:_.;_7!"--C...,,'._,___,..__ • 'Where and in ~l~ose charge_ left, Name of Phys101an called, if any, Name and P. O. Adress of Witnesses. ({•,!I I , q -- ,',_ tv .I occllPlltioll,. LocattOII, t Mine No. ................................. 8up'ts No.................................... f/tl/llC o, f(':;", : '\1 Nature and extent of Accident,£) , ~ArU/ l '1 . ~ ~ 0 r I/// J,J / t/' i J / / .'\ \y / / ~ (Signature) ~ ~- r U / d, h-__L. �, STATEMENfS QF \Vl.l J.~_Liu u - STATEltlE!:JT OF PARTY I NJURB.O • C Thi s i s to certify thnt I , th berla.nd, Wyo., April 24th, 1905. undersigned, o.t about 3 o • c lock on t he aft e r noon ot April 20th, 1905, stepped on a piece of coal, and slipped with my t'oot under tho tipple, ma.e1- 1ng one toe and bru1z1ng t wo othere. (Sjcned) Bl!ia Reeoe. .-. -I... �61\ fil/ I". b Li LJt1 0 0 ~ PACIFIC COAL CO. "' v~r • - •rJ-1 p J?IWO RT ..f f/111/IC O; .. - - - Mine No, .......................- . / ' OF PERSONA ~ INJURY. Sup'ts No ............................. ... /2,, n: , person injured, . occ11Pnt1011, o(ltc of Accide11t,~ a l.(d. Uw.-- {X,_t .J?..- ,u - r.lL A_ , .r°/ .,/},,, - -~7 / .,,,,.~ t .$ ,ZJ.. -.., -- 790 6 - Time J tr' ~f!.. ,I~ ·, . [@.,,c •1,,p1tf/0j.,_,.r_A--1L,,,(' _.,, =2~ --c . Mine No E ~ ,..,,__,.,,~,, • LoCll t ' . . ',,/J - • ~ • ntry No. Room No. . t , ; red m fl1111e, state where, u.c.,,,,,,v Y t---v I ;( 11 f If no 111~ 11 ,. • ~~ '~ ~ \ -,-' ion (' Name of Mine ~u~t. o\J ~ ~ <Name of Mine Forman, t:,. Age of Person ll1}Ured, ?- c,, Married ~ • What Family, if any, Holli long in employ, of Co.' ~~ Conditio~ of Life or Circumstances, Name and addr~ss of nearest /ru:J Relatrue, !JJJ1--1Al/, ~ ~ - C;L~ ''as he an efficient man, ~ "'as M. ~P/;,; . ('. #,-',t ,, /1})· vv, __ .I1e t emperat e, ..L--<.--<t_ l,, Where and i11 whose charge left, ~~ •-~~ - ~ Name of Physician called, if any, ~ . ,N, ~ __£;.r . {j, ( ? ~ ~~ ) 2-z I-· Name and P. 0, Adress of Witnesses. I C\\it t: f tl~ t~, lrA Nature and extent of Accident,W, ~~ (Signature) 7h. �., ' ,. ., I I' I .. J ,, I , ' .l'I ' • I ' ' �I ,, ·' ,. . ,, l I. I . I ' .• ( �I f I I • I I l ,,I I I --. .. ' �- STATE!!ENT OF JAS• sJ.lEATON, SF.OT FIRER at Hanno., ':fC inc;, lline #1• Honn Apr• 20th, 1905. On 1ipr. 14th, 1905, I une on duty na Shot :Firer in 2 ~ack Tiestor Ura and his partner start Entry. About 8.30 A• tl. I e 0 to drill a hole in cross cut ·,•om 2 ba.ck t o 2 Top Entry. I told them not to t'ire thoir shot until I cCl!le bnck and· tr.ey said al-1 · right. ,r..,_11e I was &one tl18Y fi~d t·,:., shot u,1d orono blew through to . ~ 2 Top Entry nnd injured <tnoch voughn (l?~peman) uno was there working · on pip•• · · 'When I came bnck I o.oked then uhy they fired the shot an! . . . . they said they did not !!no there ·, ,; n;•bcdy in 2 Top Entry ,: and ' r. · thought 1 t would not do any hann• (Signed) Ja.~ • Sme~ton '.-. Shot Firer. G. R. Sutton, Hine Clerk. J �,r PACIFI ' rxro,~ ,-rII~~ l l Form 123. C COAL CO. -- - of' rrwsoNAL INJURY. Ff:'l'oNf (,'11//l<' ! 8up'ts No.. V~~,,J ~ @ persoll injured, /VU/ C k _ C'Ue-L:_ 0 o,cu/1111;n, ;dent, •••• ••n••• ••• ••• • ••••• • •••~- U/ p / L/ (! ~~ 01itr of cc "(l.,Jcxl!i-v..,,1--:._. . atio11, Lt . . dill Mine, state where, (I JjllOt 111jllfe l.,,,tMineSupt: d .; person m1u1e , AgeO; /5, --<-/ i1 ~ Name of Mine Forman, ~~ . (}_ - ,; I Marned • or~~ &illgfe- 7 1~ -J- ~ c::amily, if any, WhOt f l ~ jJ- , /I .,,,~.,,.,:!no1U tong i11 employ, of Co. , . . :3 ~ ~ 44,,{_lr Condition of Life or Ciraumstan nd address of nearest lwrng Relat,ue, aes, tame a ' 1 an efficient man, ll'as ,re ~ er,;; Where and ;11 whose aharge left, //ame of p11ysiaia11 aalled, if any, 1 2,,1-. ~c/ ~ 7 //am.e and p, 0, Adress of Witnesses. ~C. 1fat11re and extent of Aaaident, 11~ -/-v~ !JZ"c~ in 2!act ~ r '~ rtner Btart evvt-,,l --/u__,,l h~e-t;(' . ~ry. I toU I\. ey eei4 all J , ~ / ) ,,,/ I (Signature) Title, - 1 ' f'-7 Was he temperate :r~,_,0lr - rJ-,..-....., ~ {)vvt./4 ~ , �------=:::; STATEMEN TS OF WITNESSES. l ... :J �STATEMENTS OF \VITNESSES. ,,·~~~~ A-.~v.n---/4 . . <~ ' - ,, 1..L. . -... . / (' / ( r, \ . /f I -;- Q ·. . ,if_-:_·. . 0 / r �STATEMENTS OF '\VITNESSES. ·H • U • . r ,,;r,e Sr :.:~.1 it'. ••.•, if • ro • • ~. • 1.. ,.: . 1 a. ;,,;1,es ~de -'fJt I ,. w. -~iii ,rh' ' ..,sida • .cc~ 'Ct..al' • (,n,Oi ·r. p.O, A s·r : l . tl lV~l'C: J t rel" tiv ,, to tl,c l i ·} ~ . tl • ,., ..... f .r t.h d tl C •. 1n hi,.. r oun,1 the t tl.c c .. . .... . t "r : ..:. . • ,.,~ . h 0 the rcor ccirJcn t a.1:: .n(J vc y 1 o c. l"G :.a rig top . hiCl' f 11 1 1. C ..., .. tiitio• of th r(o '- l-:o co 1 be n..:, 111 '. tl.o · n , fore o.t te·- irter rs t.c·e o·• Jake $ • r i . e11rl .. ,. od b,: ., l , ·t •• t:"' ... . . . - , -..,11c: -., _, . l ~ Ct' ~- 1 ) I ,,,. t.,- '- i ,,. ~ ; t. J �24, Ji'orm 12.'I. Mine No••··············-····················· f P"'°" injured, , :P. C , ,.t,"ot1,, fAcCidCllt, _ ;J , ., f -r,un, ,- »,,_,,,,t - ~-o0.,,,,--, - r~~ cJ1 "f/1'/.,,.;v~ ~- .l-f -:;-- .~ 0 _ 190 j ' ~• Mme No• . (/)~ 1 . . red ;11 f,1111e, state where, !inJ" - Time tf°.'..F'j- u "' Entry No . . -i o/.J CJ/2,, r • • / / /. J-rr;- '-..J -< -Room No. v l -iof/,line~u~Jt. /J' C,,,,-~ / f~ ~ NameofMineForman, ~ ~ ~ fl ,I , t,,o ., person IIIJllfed, '.;2. {p M • •• • C/ ;_; / [ , . , ~ ~ , \. - ,.o, . '1A,.,,'A....., amed o • ' .,J, :_tJI ram'.ly, if any, ./'; ..: r :;. I ,J0ng in employ, of ao.' ~ ..,~,,/~ - Condition of Life or Circumstances 1 ~ address of nearest liuing Relati~{ v ~;zE I OJ J, r ~ h ," \. rt • , , ' tshean efficient man, ~ Was he temperate, Jtreand in whose charge left, VWI~, . '<- of Physioian called, if any, ~ - £. . a . .r, __~, •._. 4¥-<A t 8up'ts No..... ... •••••••••••••••••••••••••• i"'! I I . •t • ,'> i'"" and P. O. Adress of Witnesses. '·, I 1,r,i'!l:l•(ti 't ,, ~ I .fl ~ oz- I - /~ tJ ...t...vf..P~ t'.n: rec ~-r ••\•t•. c"' ~ :lt ~t t t•~..i r.; 1:~ '• 't"' •• ,1ure and extent of Accident, Still b ,;'r. t. ·ecr th:, ":- 1 :r:d :r,·r tr.t :.• ·I I I r" , I I I I , (Signature) CJ ..,,,r1-:,,;c;..,~ /1-4 ' t,l...<.,._...-afil.__- �STATEMENTS OF WITN.l:!i::>~UU• t, • v1---·:,,, ?; z: -~ ·, rt / I I , f ' . ; u ~;/; r ) ./ ; . / vi,•_~,,.:~ 1 t~E~~-~ ,c .) ' ,,, ( ~-/. /1'/,,. • ,II/( ~ \, __ . ; ~ ....,~ : , I • �rJIE lJNION_ PACIFIC COAL CO . Mine No. ............................. ......... [?£POR1' OF PERSONAL INJURY. 8up'tS N0, .... •· ···········•··············· o"" Person injured, 11ame '1 . o / 17"-?Ad ~ A ____ - · - ·~ ()'} ~ c - ·)i ~ I occupation, tfl, 1/M//--n..e~ D11tc of Acoident, -i .1.11....-,z _J.n-:1 19 ,, . /'> / • 11 ( 'r Oa Time {/{/h J~- ir /./ -< - /) ''%. Location, ·c..., ✓.A,...,tt .,._ , :-kv1.-/ v , ./-J---77-v- Min , N t1. ,......tr? • t7 .' 7 v VI, //i tJnot injured in Mine, state where, (I • e o. .//-'LL Entry No. 6 frn--:r.:£ Room No. / ,J......, ~ Q C, 1 CvrvLL<l./ ~/ . Forman Nome of Mine Supt. . _. / 1 c: ~ Name of Mme c;____,_ rJ?. e of Person 111;11ree1, _ .,. ."3 o ~ . ' . Y /7. , r a / ~ Ag . . / /) •• • (/ Married • What Family, if any, ~ HotU long in employ, of Go., ~ / 0 ~ 0 d't· . . . t7 CJ_ , r on 1 ion of Life or (Jircumstances !lame and add1 ess of nearest lwmg Relative, ~----- ~ CJ!,. w11s he an efficient man, ~ ~ -✓r;-Y',._f_,,(__ ~ . C t ~ ~. ~ __,..;Was he temperate .d4n • ,,;:r'Where a11d in whose charge left, rf_O./'V , _,. . J✓. ~ Name of Physician called, if any, ./t.,, .,I..JJ1 Z'7-- './2 e7"" . iJ2 oS' (/ t;t; • (/ • JJ~ -v- • ~,,~r ' Name and P. 0. Adress of Witnesses. ~~ ~ ~ A A _ /£ ~~~--r~ /lature and extent of Accident, / ~ - - ~ - d~~ ;t/ ,,~ d ct2 -~~t?.J7??, (Signature&• T'9'-I? 9 --; Title, �\ I; l i1;., l • .,, into my p.Le.c0 "'"•( 11.11.. ,....,, t, ,. .. - C..:.1-, tho b:..c.: i •• 1· .J 1;1:<~ p1lillpC Y' ' ~ {1 ' r ... . I," ' gul t .. " r. ' ( :.:: 1 ·1 \'l.l' t ',, ... •if\•.• n l i., ' ,, l I• l''J"l'' '1 • ••' ··.,,..; n , , l'" ""' ... I . . ..... l• ,I~<> 1 --~1.. •, t,.. r. .~o\rr\c . .\ .' .... , • ••. • ' - • t r ,> .;. �C O P 1' 7 I/ I ,!l1i;_; C O r Y burned. It hu1,pcned Sa"t.,v.'rduy r.1cr1-:i.n 1_" bctr,eGri one o.nd two o' cloc ' hf.l,d been usint; ai r to .:.. pt..l'."''f1 V.'Cv ter cut of' the slope with, about 40 or 45 mi nut.0~: as fc.r G. ~.., J. !:r10·\7 , whon 1:.r r, o Bell told me to r;; top purr.ping an<'i to turn a:lr into tho 9 th back entry to blor. gaE out .. PJ.r hr1c1. bf;en eoin1.3 about .fi vc minutes when l1e [;O in to see j_f i t He got as far as the turn r.:1•1.:..ti o.t, mout h of the entry v::hcn h r; net gas coming out, e,nd 1 t lit as he was putting his nakea 1:lZ,ht dov:n .. After ignition t-.:r. l:cll exa.n1in0d both entries and then ,l·c nt out of mine .. (Sisncd) Jas. Dosv.·orth. �btl..." .·-~ . ::l . '(,n. t ( {-.., •'r10 . •., ,..,., -.., Vl:J.8 ll o.l:ou ~, i7'\. ' .. "''O r "•c:1t i H,o t t-..., ,... thr.re v ..., •• ,J f ct out L1 t he entr ( , !. ;" •1r1 _,.., - t~l , ·.·, ,-; ••. ·l ' 4J, • • \ .. ~J.i,Ght Poremun. , �G~ ,-.v o lo · trON' pACJPIC COAL CO. tll~ tJN 7 --- ,r OF PERSONAL INJURY. Mine No.. ................... 'J 0I• ~l ~ 1 8up'ts No.. (.,i ,; person injured, 1 ' ;J,? • tf2 1 ,patio//, acri if Acaident, /'/4 ../ f ,/4.,V( r....~ 1•~111C OJ • .g / - ;(Zt.-;- "' 1,,L 1 11 J._,, / IJ1 a;?'--<--(.,-(_ - -~~ . /Jl-,rf-- t, -:-f}__,,v v,/J.,J.Ji~ ' f l ~ oat~: 11 /,Ora ~ ,~ared in Mine, state where, 11~ ~ , ,e oif r,1i11e Supt. ,; Person m1ured, Jgc O~ Vhat family, if any, 1,;n (J (' . \. . IA./IAA...£¢,1 , I ~ ,_; A7'- 7 ••••• • • ••••••••••••• •••••• ••••u•• 790 d - Mine No. , i~~ Name r: fl -1- J 1me l- {.....t,.-v-vtA..., ,) ( J () C( 111, Entry No. I/ Sv-,,4 Room-No. /J;J,,. _ .,/ ,-F M' r 0:1 m e rorman IJ . , ~~ . tJ ~ L~ , Mamed , • • 7 , /1-' ~ ,1 • 7~~ v - tJ ~ J./ ::t-~ ~ow tong in employ, of Co., Condition of Life or Circu Jame and address of nearest humg Relative, ~ - ~( y~ instances, 11ea11ejjiaie11tman, ·rr7:-) 118 . C), Was he temperate 1,a 17 1 Where and in whose charge left, v'~ J/h-,1. ,._ , ~ uame of Physician called, if any, ~ A---~ fo . J· 1Jl.,J., ~y- g ~~J,?-~ M _ (/ • •~ /lame and P. 0, Adress of Witnesses. /lature and extent of Accident, & 0/ ~~~~-✓¥-/f-..-rvv~~ .,. Cause, _Q _ y?/, $ - ~ {7 ' 0A c£ (Signature) I 1f'()0 - Title, t;' .....-- Q -~ ~ JP~~ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Union Pacific Collection Description An account of the resource This collection is made possible in part by a generous grant from Wyoming Humanities. All materials are the property of Union Pacific Coal Company, on long-term loan at Western Wyoming Community College. For usage inquiries, contact the <a href="https://www.uprrmuseum.org">Union Pacific Museum</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Record of Personal Injury #9 Rights Information about rights held in and over the resource CC BY-NC-ND Date Created Date of creation of the resource. 1903-1905 Subject The topic of the resource Records, injuries, accidents, Rock Springs mines Description An account of the resource 14" x 8.5" book with black cover and red spine. Collection of records regarding injuries and accidents within Rock Springs mines. Some pages are severely faded making them hard to read. Type The nature or genre of the resource Text Creator An entity primarily responsible for making the resource The Union Pacific Coal Co. Identifier An unambiguous reference to the resource within a given context 1-0017 Publisher An entity responsible for making the resource available The Union Pacific Coal Co.