140 W. & L..E. GURLEY. TROY. NEW YORK 



DEPARTMENT *>i un I.MHUOK FILE No. 



i \ITI.I' ST\TI:S .,] ,i< \i. si i:\ m 



\\ VTKR RE8OUBCEH ia;\\ II \\ M-liili-t 'II 



Pate I'.'--'... Field 



1 \M' I loN ii| A I l"\l A I li (I M.I 



:lt 



_'a;:c \\orkiiiK properly \\lieii you ivai-hcd il ' 

 What IH correct time l.y your watch? 



What is th.' rlnrU ti.nrV _ _. 



What is the thin- hy tin- JM-H ..r IM-U.-M ': 



What is tlu outside i.r river ap' n:uliiiK ? - 



What is tin- insule or well ^a^'e n-aliiitf ? 



What \s the automatic jrajre rea.linu' 'i 



Have you marked pen or pencil time on the chart l,y raising the n.-.u -. 



lid you remove old sheet and put on new one ? At what ti 



did you do this? 



It' \oii did not remove sheet, did y-m correct setting of pen or pencil and 



clock ? 



Did you wind clock ? Regulate it ?__. 



Did you sharpen pencil or fill pen ? 



Did you mark pen or pencil time on new sheet hy raising float ? 



Have you tilled blanks on old sheet according to Instructions? 



Have you made sure that pen or pencil is down, sheet placed corn-- tl\. wl 



screw on drum fastened, and gage working correctly before 



station ? 



Have you tilled all blanks on this sheet a<-cordin to instructions ? 

 KemarkH and questions : 



Signed by__ 



0rp0r. 



i - il Survey Form for inspection of 



Recording Register Stations. 



