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A. Administrative <br />B. Hydrologic Balance <br />C. Topsoil & Subsoil <br />D. Backfilling & Grading <br />E.  Excess Spoil Disposal <br />F.  Coal Mine Waste  <br />      (Refuse Piles/Impoundments) <br />G.   Use of Explosives <br />Subsidence Control Plan <br />I.   Roads <br />J.   Signs & Markers <br />1 <br />1 <br />1 <br />1 <br />1 <br />1 <br />1 <br />Mining within Valid Permit <br />Mining within Bonded Area <br />1. <br />2. <br />3.Terms & Conditions of Permit <br />4.Liability Insurance <br />5.Ownership and Control <br />6.Temporary Cessation <br />7.AML Rec. Fees - Non-Respondent <br />8.AML Rec. Fees - Failure to Pay <br />1.Drainage Control <br />2.Inspections & Certifications <br />3.Siltation Structures <br />4. <br />Diversions5. <br />Effluent Limits6. <br />Ground Water Monitoring7. <br />Surface Water Monitoring8. <br />Drainage - Acid-Toxic Materials9. <br />Impoundments10. <br />Discharge Structures <br />11.Stream Buffer Zones <br />1. <br />2. <br />3. <br />4. <br />Removal <br />Substitute Materials <br />Storage and Protection <br />Redistribution <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7.Stabilization (rills and gullies) <br />Handling of Acid and Toxic Materials <br />Steep Slopes (includes downslope) <br />Highwall Elimination <br />Approximate Original Contour <br />Contemporaneous Reclamation <br />Exposed Openings <br />1. <br />2. <br />3. <br />4.Inspections & Certifications <br />Surface Stabilization <br />Drainage Control <br />Placement <br />1. <br />2. <br />3. <br />4. <br />5.Impounding Structures <br />Inspections & Certifications <br />Placement <br />Surface Stabilization <br />Drainage Control <br />1. <br />2. <br />3. <br />4. <br />5.Control of Adverse Effects <br />Warnings & Records <br />Blast Survey/Schedule <br />Distance Prohibitions <br />Blaster Certification <br />H. <br />1. <br />2. <br />3. <br />4. <br />5. <br />1 <br />1 <br />Road Construction <br />Certification <br />Drainage <br />Surfacing and Maintenance <br />Reclamation <br />1. <br />2. <br />Signs <br />Markers <br />K.Distance Prohibitions <br />L. Revegetation <br />1. <br />2. <br />Vegetative Cover <br />Timing <br />M.1 Postmining Land Use <br />N. Other <br />General <br />Performance <br />Category <br />28. Performance Standard Categories <br />Codes:1=Compliance, 2=Noncompliance, 3=Not Planned, 4=Not Started, 5=Noncompliance Identified Elsewhere, 6=Previously Cited, 7=Permit Defect <br />Page of <br />OSM Action <br />1) Deferred to State Action <br />2) TDN Issued <br />3) NOV Issued <br />4) FTA-CO Issued <br />5) IH-CO Issued <br />6) ID-CO Issued (Imminent Danger to Public) <br />7) Previously cited by RA, abatement pending <br />8) Abated during or before OSM inspection <br />9) Follow-up of Federal Action <br />0) Off-site impact with no violation <br />Off-Site Impacts <br />For each type of impact and resource affected, enter <br />"N, D, or J" to describe the degree of off-site impact: <br />N - Minor Occurrence <br />D - Moderate Occurrence <br />J - Major Occurrence Revised October 1, 2010 <br />2 2 <br />U.S. DEPT. OF THE INTERIOR <br />OFFICE OF SURFACE MINING <br />Mine Site Evaluation <br />Permittee/ <br />Person MOUNTAIN COAL COMPANY LLC <br />Permit <br />Number C80007 <br />Field Visit <br />Date 6/3/2019 State Program <br />Continuation Page