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For The Foll~wi~ig Entries, Circle The Appropriate Choice: = nspe.-, e an oun in comp lance, NA = Inspection Topic not applica:>le, N = Nit Inspected, R = Inspected and comments noted, V = Inspected and Violations (NOV) or Cessation Oraer (CO) issued, B = Inspected and both Comments noted & Violations or Cessation Ur der issued, T 10 Day Notice Issued by OSM Oversight Personnel, S =Sample taken and sent to the lab from analysis - describe type ana location of sample taken under comment section. GENERAL INSPECTION TOPICS: CORDS........... L Y/ NA i N /Q / V / B / T / S LCJ SIGNS AND MARKERS ................. lCr3 / NA / N / R / Y / B / T / S J LCJ ROADS ............................. L~/ NA / N / R / V / B / T / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N / ®/ Y / g / T / S J LCJ BACKFILL 8 GRADING ................ L~Y / NA / N / R / V / B / T / 5 J lC] EXPLOSIVES ........................ L Q/ NA / N / R / Y / 8 / T / S J LCJ PROCESSING WASTES ................. L Y / N® / N / R / V / B / T / S J LCJ SUPPORT FACILITIES ................ LQ1 / NA / N / R / V / B / T / S J LCJ TOPSOIL ........................... L~Y / NA / N / Q / V / B / T / $ J LCJ GENERAL MINE PLAN COMPLIANCE,,,,,, / NA / L Q N / R / V / B / T / $ J LCJ FISH 8 WILDLIFE ................... ~ // LUJ/ NA / N / R / Y / B / T / S J LCJ REVEGETATION ...................... L Y/ N~ / N / R / V / B / T / S J LCJ AIR RESOURCE PROTECTION........... L ©/ NA / N / R / V / B / T / S J LC] SLIDES 8 DAMAGE ................... L Y /~ / N / R / V / B / T / S J LCJ SUBSIDENCE ........................ L Y / ~ / N / R / V / B / T / S ] LCJ EXCESS SPOIL & DEVELOPMENT WASTE.. L Y / NC~ / N / R / V / B / T / S ] LCj OFFSITE SUPPORT FACILITIES........ L Y / NUA / N / R / V / B / T / S 7 LCJ RECLAMATION SUCCESS ............... L Y / ® / N / R / V / B / T / S LCJ SPECIAL CATEGORIES OF MINING...... L Y / N® / N / R / V / B / T / 5 1 (1) L20 (2) -------------------- Spaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - LCJ 07HERS ............................ L Y / NA / N /~/ V / B / T ] (3j -------------------- MaxJ NOTE: lCJ Required Entry.