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<br />r <br />,~ ~ <br />iii ~«iii~~nmiu <br />Page i or T Popes <br />~~~~ <br />U <br />i <br />d S <br />D ~~ <br />n <br />te <br />tates <br />epartment of the <br />Office of Surface Mining <br />Mine Site Evaluation Inspection Inter <br /> <br />Report NOY 1 21 For Offic <br /> <br />83~ e Use Only <br /> <br />1~ 1~ <br /> MINED ND <br /> <br />RECLAMATION r v M M <br />IVISION Balcn Reovrt <br /> 10. Date of Inspection <br />2. Name of Permit tee 9. MSHA Number (V Y M M D 01 <br /> r E ti I G ^ ~ .- I/ ~1 S ~ C O G ~o ~ll ~ 7. I SL1c7 ~~ <br /> 3. Scree[ Address 11. Slate Permit Number <br /> ~ ~. r ~ x l i c 3~-511 ~la.~oi<I~DI ~ ~ <br />4. City 5. Slate 12. Name of Mine <br /> <br />) <br />~ <br />t~ <br />~ <br />co <br />~~e <br />r <br />o12l .s. <br />~ <br />1IY' <br />{ il ~ <br />r~ <br />1 <br />~ <br />~ <br />~ <br />Code 7. Area Code 8. Telephone Number <br />6. Zi p 17. County Code 14. State Code 15. Strata 16. Sla;c Arca OfLCe <br />) <br /> <br />17. OSbI Field t6. OSM Area t9. OSht 20. Type of Icspeclicr. 21. Joint Inspec hen 22 mspertor~s ID <br />Otlice No. Olbce No. Sample No. <br />~ (Cotlz) Yes ~IIN--o ;;I <br />I ~ Nom' <br />L' 1 <br />~. V ~ ~ ,~ i <br />~ ^I i J ~' <br /> <br />23. Status 24. Tgpz el Ac; vrty Ic?eck appbwblz co rest. <br />A O, 1/ Type cf Permit <br />a StezF Slope <br />E i~ Anlhrarile <br />8 ~ Mine Status (Code) <br />0 ~ Mountain iop Removal <br />F [~ Federal Lands <br />C / p Type of Facility (Code) <br />C ^ Prime Farm lantls <br />G ^ Indian Lands <br />D C. 7 ~ D • ~ Number of Pe!mitte0 Acres <br /> <br />E C O O d 5 • O Number o1 Disturbed Acres D ~ Alluvial Valley Floors H ~ Other <br />25. Performance Stands rtls lCodesl <br />Instructlana: Indicate ,:cmpliance code FJr any standard marked 2 0! 7 prdvitle narrative In suppo't Inis determination. <br />Standards That limit the Etfects to the Permd Area Standards That Assure ReU am al~or. Cunlily and Timeliness <br />A ~ Distance ProhiDilions .M ~ Topsoil Hand bng <br />0 ~ Mintng Wllnin Permit Boundaries N ~ Back!Ilung and Grading <br />C ~ Signs and Markers O ;~ Follo+ring Reclamation Schetlnle <br />D ~^ Sediment Control Measures P ~ Revegelation Requirements <br />E ® Design and Certiflcallan Requirements- O ® Disposal of Excess Spoil <br />Sediment Contrpl <br />R © Handling of Acid or Toxic Materials <br />F ~ Etfluenl Limits <br /> S ® Hlghwall Eliminalion <br />G ~ Surface Water Monitoring <br />T ~ Downslope Spoil Disposal <br />H ®Ground Water Monitoring ~ ~ .. <br /> <br />I a Blasting Procetlures U ~ Post Mining Land Use <br /> V ~ Cessahon of Operations: Temporary <br />J ~ HaullACCess Road Design and Maintenance <br />W ~ Other <br />K ~ Refuse Impoundments <br />L ~ Otner: Specify <br />Dismbunon: Original ~ Field Ofhce. Green ~ Headouarlers. Blue ~ $ta le's Copy, Yellow ~ Inspector's Copy. Pink File Copy IE ~ 169 (1167) <br />