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~t.l ' III IIIIIIIIIIIII III <br /> <br />MAR 101986 <br />Pepe 1 of t vapaa <br />artment of the ~60rLAND RECLA <br />United States De ATIONF <br />Offi U <br />l <br />O <br />p <br />f S <br />Offi <br />f <br />Mi <br />i <br />Of Neturai R <br />Dept <br />1 <br />0 or <br />se <br />n <br />y <br />ce <br />OufCeS <br />ce o <br />ur <br />ace <br />n <br />ng . <br />0. <br />0 <br /> <br />Mine Site>Evaluation Inspection Report 1a <br />~ ib tc <br />~ m <br /> Y Y M M Batch Report <br /> <br />2. Name of Permittee <br />9 MSHA Number 10. Date of Inspection <br />(V Y M M D D) <br /> J <br />J <br /> 3. Street Adtlress 11. Slate Permq Number . <br /> ~ <br /> <br /> 4. City 5 State 12. Name of Mine <br /> I ~ ,~{ <br />6. ZIPCotle 7. Area Code 6. Telephone Number tJ County Code id. State Cotle t5. Strata <br />I r6. State Area Office <br />17. OSM FIe10 16. OSM Area 19 OSM 20. Type o7 lespechor. 21. Joint inspection ?2 Inspector's ID <br />Olllce No. Office No. Sample No. <br />~ ICodef Yes No <br />1-J~LLJ Nq. <br />23. Status 24. Type pf Activity jC'+eck applicable boxes) <br />A r~ j Type of Permit <br />r <br /> <br />8 ~ Mine Status ICo0e1 A i_ Sleep Slope E i Anlhracila <br /> <br />C Type of Facility ICotlel <br />m B ~ Mounlam fop Removal F L~ Federal Lands <br /> C ^ P(Ime F?r T!dnds G ^ Indrdn Ldn'ds <br />D ~ Number of Pe,m ittetl Aues <br />D ~ Alluvial Valley Floors <br />H i~ Other <br />u <br />E ~ Number of Dist urDeO Acres <br />25 Performance Standards fCOdesl Y- .- - - - ~ ._ _ <br />Inefrudlone: Indicate compliance code. For any stantlartl marked 2 or 3 provide nairalive m support This determinalinn <br />Stantlards That Limn the Effects to the Permit Area Stantlards That Assure ReU amvior. Cu~hty and Timelineos <br />A ~ Distance Prohibitions M ~ Topsoil Handling <br />B ~ Mining Within Permit Boundaries N ~ Back!ilbnq and Grading.` ~ ~ - - .~ <br />C ^ $Igns and Markers O L FCllptving ReUamaYOn Schec4ile , <br />D ~ Sediment Control Measures -' P ~ geveyetabon Requnemer,ls <br />E ~ Design and Certiflcatwn Requirements- O ~ Disposa: of Excess Spoil <br />Sediment Control <br /> <br />F ~ Effluent Limlis <br />R ~ Handling of Acrd or Toxic Materials <br /> <br />G ~ Surface Water Monitoring ~ ~ ~ ~ ~ S ^ Highwall Elimination <br />' <br /> <br />H ~ Ground Water Monitoring T ~ Downslope Spgil Disposal <br /> U^. Post Mining Land Use <br />I ~ Blasllnp Proce0ure5 <br /> <br />J ~ Haul/Access Road Design and Maintenance - - V ~ Cessation of Operations Temporary <br />-~ _ <br />- <br /> <br />K ~ Refuse Impountlments W ~ Other -- <br />L ~ Other: Specify <br />Dlelribulion: Original -Field Oflica, Green <br />// , <br />Headquarters/Blue ~ Stat~pw <br />r'~' <br />Inspector's Copy Pink ~ File CoDY IE ~ t631t/fiJ) <br />