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-} ~ ~ IIIIIIIIIIIIillllll <br />' Pape t of Z Pepes <br />United States Department of the Interior For Office Use Onty <br />Office of Surface Mining <br />Mine Site Evaluation Inspection Report ,a <br />~ ,b ,c <br />m m <br /> V Y M M Batt11 Report <br /> 10. Date of Inspection <br />2. Name of Permiltea 9. MSHA Number (Y Y M M D D) <br /> <br /> 3. Street Address 11. State Permit Number <br /> - 4 r ~ v <br /> _ <br />4. City <br />5 <br />. <br />S <br />tate 12. Name of Mine <br /> m <br /> f ~ <br />. ~ <br />6. Zlp Cotle 7. Area Code R. Telephone Number 13. County Code 14. Slate Code 15. Strata 16. State Aree Office <br /> <br /> <br />17. OSM Field 18. OSM Area 19. OSM 20. Type of Inspection 2t. Joint Inspection 22. Inspector's ID <br />Office No. Ollice No. Sample No. (Cotle) Yes <br />N~o <br />~ ~ No. <br /> ~1 <br />I <br />~ <br />LJ ~ ~ <br />23. Status 24. Type of Activity (check applicable boxes). <br />A ~ Type of Permit <br />A ~ Steep Slope <br />E ~ Anthracite <br />B ~ Mine Status (Code) <br /> <br />C Type of Facility (Cotle) <br />m B ~ Mountain Top Removal F ~ ~ Federal Lends <br /> C ~ Prime Farmlands G ~ Indian Lands <br />D L~ (; ~ r • (; Number of Permittetl Acres D ~ Alluvial Vall9y Floors H O <br />h <br /> <br /> <br />E (~ O 1 j • ;) Number of Disturbed Acres ^ <br />er <br />t <br />25. Performance Standards (Cotles) <br />Inatructbna: Intlicata compliance code. For any stantlerd marked 2 or 3 provbe narrative to support Ihis determination. <br />Standards That Limit the Effects to the Permi[ Area Standards That Assure Reclamation Quality antl Timeliness <br />A ~ Distance Prohibitions M ~ ioDSOiI Hantllinp <br />e ~ Mlning Within Permit Boundaries N ~ Backlilling antl Gratling <br />C a Signs antl Markers O ~ Following Reclamation Schetlule <br />D ®Sedlment Canirol Measures P ID Revegetation Requirements <br />E ~ Design and Certlflcatlon Requirements- O ~ Disposal of Excess Spoil <br />Sedlment Control <br /> <br />F ~ Ellluant Llmlts <br />R ~ Handling of Ac10 or Toxic Materials <br /> S ^i Hlphwall Elimination <br />G /~ Surleca Water Monltoring <br />T ~ Downslope Spoil Disposal <br />H ~ Ground Water Monltoring <br /> <br />1 ~ Blasting Procetlures U ~ Post Mining Land Usa <br /> <br />J ~ Haul/Access Roatl Design antl Maintenance V ~ Cessation of Operations: Temporary <br /> <br />K ~ Reluse Impoundments W ~ Other <br />L ~ Other: Specify <br />Distribution: Original - Flald Office, Green - Heatlquarters, Blue -State's Copy, Vellow ~ Inspector's Copy, Pink ~ File Copy IE ~ 163 (1/83) <br />~~ <br /> <br />