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<br /> <br />For The Following Entries, Circle The Approrpiate Choice: <br />= nspecte an ou- n~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 />~ <br />C AVAILABILITY OF RECORDS........... [ Y <br />/ NA / N / R / V / B / T / S ] <br />[C] SIGNS AND MARKERS ................. [ 1~( / NA / N / R / V / B / T / S ] <br />[C] ROADS ............................. [ Y / NA / N / ~/ V / B / T / S ] <br />[C] HYDROLOGIC BALANCE ................ [ Y / NA / N /~R / V / B / T / S ] <br />[C] BACKFILL & GRADING ................ [ Y / NA / N /® / V / B / T / S ] <br />[C] EXPLOSIVES ........................ [ ©/ NA / N / R / V / B / T / S ] <br />[C] PROCESSING WASTES ................. [~Y / NA / N / R / V / B / T / S ] <br />[C] SUPPORT FACILITIES ................ [Q / NA / N / R / V / B / T / S ] <br />[C] TOPSOIL ........................... [ Y / NA / N /~R / V / B / T / S ] <br />[C] GENERAL MINE PLAN COMPLIANCE...... [~/ NA / N / R / V / B / T / S ] <br />[C] FISH & WILDLIFE ................... [~j NA / N / R / V / B j T / S ] <br />[C] REVEGETATION ...................... [ Y / NA / N /CR / V / B / T / S ] <br />[C] AIR RESOURCE PROTECTION........... [~/ NA / N / R / V / B / T / S ] <br />[C] SLIDES & DAMAGE ................... [CY/ / NA / N / R / V / B / T / S ] <br />[C] SUBSIDENCE ........................ [ Y / NSA / N / R / V / B / T / S ] <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE.. [Q / NA / N / R / V / B / T / S ] <br />[C] OFFSITE SUPPORT FACILITIES........ [ Y /(N~ / N / R / V / B / T / S ] <br />[C] RECLAMATION SUCCESS ............... [Q / NA / N / R / V / B / T / S ] <br />[C] SPECIAL CATEGORIES OF MINING...... [ Y /~NA~ / N / R / V / B / T / S ] <br />(1) -------------------- [20 <br />(2) -------------------- Spaces <br />(3) ------------ ------- Max] <br />[C] OTHERS ............................ [ Y /CN / N / R / V / B / T ] <br />~Z~ -------------------- [Spaces <br />(3) -------------------- Max] <br />- - - - - - - - - - - - - - - - - - - - <br />NOTE: [C] = Required Entry. <br />