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i • • <br />,. <br />For The Following Entries, Circle The Approrpiate Choice: <br />-~ = Inspected and found in compliance, <br />NA = Inspection Topic not applicable, <br />N =Not Inspected, <br />R =Inspected and Comments noted, <br />V =Inspected and Violations (NOV) or Cessation Order (CO) issued, <br />B =Inspected and both Comments noted & Violations or Cessation <br />Order issued, <br />T = 10 Day Notice Issued by OSM Oversight Personnel, <br />S =Sample taken and sent to the lab from analysis -describe <br />type and location of sample taken under comment section. <br />GENERAL INSPECTION TOPICS: <br />C AVAILABILITY OF RECORDS........... [ Y / NA / N / R!~/~V / B / T / S ] <br />[C] SIGNS AND MARKERS ................. [ Y/'X NA / N / R / V / B / T / S ] <br />[C] ROADS ............................. [ Y / NA / N / RU V / B / T / S ] <br />[C] HYDROLOGIC BALANCE ................ [ Y / NA / N / R~ V / B / T / S ] <br />[C] BACKFILL & GRADING ................ [ Y / NA / N / RAJ V / B / T / S ] <br />[C] EXPLOSIVES ........................ [ Y / NAj N / R / V / B / T / S ] <br />[C] PROCESSING WASTES ................. [ Y / ~-~( N / R / V / B / T / S ] <br /> <br />[C] SUPPORT FACILITIES ................ [ Y / NA / N / R~ V / B / T / S ] <br />[C] TOPSOIL ........................... [ YIl-/~ NA / N / R / U / B / T / S ] <br />[C] GENERAL MINE PLAN COMPLIANCE...... [ Y//~y, NA / N / R / V / B / T / S ] <br />[C] FISH & WILDLIFE ................... [ Y / NA / N / R / V / B / T / S ] <br />[C] REVEGETATION ...................... [ Y / NA / N / R~ V / B / T / S ] <br />[C] AIR RESOURCE PROTECTION........... [ Y~ NA / N / R / V / 6 / T / S ] <br />[C] SLIDES & DAMAGE ................... [ Y / NA / N / R~/, V / B / T / S ] <br />[C] SUBSIDENCE ........................ [ Yr/~,NA / N / R /V V / B / T / S ] <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE.. [ Y <br />NA / N / R / V / B / T / S ] <br />[C] OFFSITE SUPPORT FACILITIES........ [ ~ <br />Y NA / N / R~ V / B / T / S ] <br />[C] RECLAMATION SUCCESS ............... [ Y / NA / N / R F/'1 <br />~ V / B / T / S ] <br />[C] SPECIAL CATEGORIES OF MINING...... [ Y / N~ N / R <br />/J V / B / T / S ] <br />(1) -------------------- [20 <br />(2) -------------------- Spaces <br />(3) -------------------- Max] <br />[C] OTHERS ............................ [ Y / NAB N / R / V / B / T ] <br />(1) <br />(2) -------------------- <br />(3) -------------------- <br />- - - - - - - - - - - - - - - - - - - - <br />[20 <br />Spaces <br />Max] <br />NOTE: [C] = Required Entry. <br />