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• • <br />-.. r~_ <br />For The Following Entries, Circle The Approrpiate Choice: <br />r = inspectea ana touna in compliance, <br />NA = Inspection Topic not applicable, ~ <br />N =Not Inspected, ~ <br />R = Inspected and Comments noted, <br />V = Inspected and Violations (NOV) orCessation Order (CO) issue <br />B = Inspected and both Comments noted.i: 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 />[('1 AVAILABILITY OF RECORDS........... [ Y / NA / N /,R / V / B / T / S ] <br />[f] SIGNS AND MARKERS ................. [ Y / NA / N /~R / V / B / T / S ] <br />ji.] ROADS ............................. [ Y / NA / N /~R / V / B / T / S ] <br />[t,] HYDROLOGIC BALANCE ................ [ Y / NA / N /R / V / B / T / S J <br />[l;J 6ACKFILL & GRADING ................ [ Y / NA N /R / V / B / T / S ] <br />[(:] EXPLOSIVES ........................ [ Y / NA / N /jR / V / B / T / S ] <br />[C] PR(1CESSING WASTES ................. [ Y / NA / N /~R / V / B / T / S ] <br />[C] SUPPORT FACILITIES ................ [ Y / NA N /IR / V / B / T / 5 ] <br /> <br />[C] TOPSOIL ........................... [ Y / NA / N /R / V / B / T / S ] <br />[C] GENERAL MINE PLAN COMPLIANCE...... [ Y / NA / /IR / V / B / T / S ] <br />[C] FISH & WILDLIFE ................... [ Y / NA / ~ <br />N /R / V / B / T / S ] <br />[C] REVEGETATION ...................... [ Y / NA /~ /~R / V / B / T / S ] <br />[C] AIR RESOURCE PROTECTION........... [ Y / NA / N /R / V / B / T / S ] <br />[C] SLIDES is DAMAGE ................... [ Y / NA / N /jR / V / B / T / S ] <br />[C] SUBSIDENCE ........................ [ Y / NA / N / R / V / B / T / S ] <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE.. [ Y / NA / N /~/ V ! B / T / S ] <br />[C] OFFSITE SUPPORT FACILITIES........ [ Y / NA / N /.R / V / B / T / S ] <br />[C] RECLAMATION SUCCESS ............... [ Y / NA / N / R / V / B / T / S ] <br />[C] SPECIAL CATEGORIES OF MIMING...... [ Y / NA / N /IR / V / 8 / T / S ] <br /> (1) ----------- - - - - ~ - - - - [20 <br /> (2) Spaces <br /> ----------- <br />(3) ----------- - <br />- - <br />- - <br />- - <br />- - <br />=- - <br />- - <br />- - <br />- <br />Max] <br />(C] OTHERS ............................ [ Y / NA / N / IR / V / B / 7 ] <br /> <br /> _ <br />_ <br />__ <br />(2) _ _ _ _ __ _ _ _ Spaces <br /> _ <br />_ <br />_____ <br />(3) ----------- - - - - -- - - - Max] <br />NOTE: [C] = Required Entry. <br />R } ,~ k .. <br />..}r~:.r l.if.'~ ~'..IIEQ.Y. Le. :.,..~ .Ya r~ f <br />... tb;. :S. ..:~_~ <br />~~ <br />,r <br />'~: <br />,~.L <br />j ~ ~. <br />~~ <br />I, ,~ .~ <br />4Y ~.I3 _ ... .4 rV4~{CiL <br />