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<br />,- ~ <br />n <br />C ~ <br />C~ <br /> For The Following Entries, Circle The Approrpiate Choice: <br />" ~ = Tnspecte3 and~oun d-in compT'iance, <br /> NA = Inspection Topic n ot applicable, <br /> N =Not Inspected, <br /> R =Inspected and Comments noted, <br />+ V =Inspected and Viol ations (NOV) or Cessation Order (CO) issued, <br /> B =Inspected and both Comments noted & Viol ations o r Cessation <br /> Order issued, <br /> T = 10 Oay Notice Issu ed by OSM Oversight Person nel, <br /> S =Sample taken and s ent to the lab from an alysis - describe <br /> type and location of sample taken under comment section. <br />GENERAL INSPECTION TOPICS: <br />C AVAILABILITY OF R CORDS........... [ Y / NA /©/ R / V / B / T / S ] <br />[C] SIGNS AND MARKERS ................. [(~/ NA / N / R / V / B / T / S ] <br />[C] ROADS ............................. [~Y / NA / N / R / V / B / T / S ] <br />[C] HYDROLOGIC BALANCE ................ [ Y / NA / N /®/ V / B / T / S ] <br />[C] BACKFILL & GRADING ................ [ Y / NA /ON / R / U / B / T / S ] <br />[C] EXPLOSIVES ........................ [ Y / N~ / N / R / V / B / T / S ] <br />[C] PROCESSING WASTES ................. [ Y / NA / N / R / V / 8 / T / S ] <br />[C] SUPPORT FACILITIES ................ [QY / NA / N / R / V / B / T / S ] <br />[C] TOPSOIL ........................... [ Y / NA / N / RO/ V / B / T / S ] <br />[C] GENERAL MINE PLAN COMPLIANCE...... [~/ NA / N / R / V / B / T / S ] <br />[C] FISH & WILDLIFE ................... [ Y / NA / N ~/ V / B / T / S ] <br />[C] REVEGETATIDN ...................... [ Y / NA / N /($7 / V / 8 / T / S ] <br />[C] AIR RESOURCE PROTECTION........... [UY / NA / N / R / V / 6 / T / S ] <br />[C] SLIDES & DAMAGE ................... [ Y /~/ N / R / V / B / T / S ] <br />[C] SUBSIDENCE ........................ [ Y / N / N / R / V / B / T / S ] <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE.. [ Y / NA / N / R / V / B / T / S ] <br />[C] OFFSITE SUPPORT FACILITIES........ [ Y / ~A / N / R / V / B / T / S ] <br />[C] RECLAMATION SUCCESS ............... [L.J~ NA / N / R / V / B / T / S ] <br />[C] SPECIAL CATEGORIES OF MINING...... [ Y /® / N / R / U / B / T / S ] <br />(1) -------------------- [20 <br />(2) Spaces <br />(3) -------------------- Max] <br />- - - - - - - - - - - - - - - - - - - - <br />[C] OTHERS ............................ [ Y / NA / N / R / V / B / T ] <br />{1) -------------------- [20 <br />{2) Spaces <br />(3) -------------------- Max <br />NOTE: [C] = Required Entry. <br />z ,..~,p.,, . ~.:. I -- <br />