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AVS Annual Review <br />Inspection Worksheet <br /> <br />Date 24 October 2013 <br /> <br />Mine Name/Permit Number Trapper Mine; C-1981-010 <br /> <br />Inspector Signature <br /> <br />Based on your ON-SITE Observation, please answer the following: <br /> <br />1) Mine ID sign <br /> <br /> a) Permittee Trapper Mining, Inc. <br /> <br /> b) Operator Trapper Mining, Inc. <br /> <br /> c) MSHA ID Not on sign (not required to be on sign) <br /> <br />2) Direct inquiry (of persons on the site) <br /> <br /> a) Permittee Trapper Mining, Inc. <br /> <br /> b) Operator Trapper Mining, Inc. <br /> <br /> c) MSHA ID 0502838 <br /> <br />3) Is ownership/control information for permittee and operator noted in field consistent with <br />what is listed in the permit application? Yes x No _______ <br /> <br />If No, what is in conflict? <br /> <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br /> <br />DRMS is required to verify this information as specified in the AVS MOU if the permitting action was <br />approved subsequently to the MOU (renewal, transfers and revisions). Annually as long as coal <br />extraction from the site has not been completed, DRMS must determine whether officer/controller <br />information is complete and accurate in AVS. In making the determination of complete and accurate <br />information, on-site observations and direct inquiry of persons on the site is necessary. The information <br />on this form will be verified with AML, MSHA, and EIA information in AVS. Please return the form to <br />Mary Rodriguez to be verified in AVS. <br />