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3 <br />For The Fol1~„i:lg Entries, Circle The Appropriate Choice: <br />= nSp?C a an Oun In Comp lance, <br />NA = Insp?c ti on Topic not applica~l?, <br />N Nit Inspected, <br />R = Inspectea and Comments noted, <br />V Inspected and Violations (NOVI ur Cessation Order (CO) issues, <br />8 Inspected and both Comments noted 8 Violations or Cessation <br />Order issued, <br />7 = 10 Day Notice Issues by OSM Oversight Personnel, <br />S =Sample taken and sent to the lab from analysis - describe <br />type ana location of sample taken under co mnent section. <br />GENERAL INSPECTION TOPICS: <br /> CORDS........... I Y / NA / ®/ R / V / B / T / S ] <br />LCJ SIGNS AND MARKERS ................. L © / NA / N / R / V / 8 / T / S ] <br />LCJ ROADS ............................. L Y / NA / N / ® / V / B / T / S J <br />LCJ HYDROLOGIC BALANCE ................ L Y / NA / N /CBS / V / 8 / T / S ] <br />LCJ BACKFILL 8 GRADING ................ L Y / NA / ©/ R / V / B / T / S ] <br />LCJ EXPLOSIVES ........................ 1 Y / NA /~/ R / V / B / T / S ] <br />L~:J PROCESSING WASTES ................. L Y / ~ / N / R / V / B / T / S J <br />LCJ SUPPORT FACILITIES ................ L © / NA / N / R / V / B / T / S ] <br />L~] TOPSOIL ........................... L Y / NA / ®/ R / V / B / T / 5 ] <br />LCJ GENERAL MINE PLAN COMPLIANCE.,,,.. L Y / NA / ©/ R / V / B / T / S ] <br />LCJ FISH 8 WILDLIFE ................... L ©/ NA / N / R / V / B / T / S ] <br />LCJ REVEGETATION ...................... L Y / NA / ®/ R / V / B / T / S ] <br />LCJ AIR RESOURCE PROTECTION........... Lam / NA / N / R / V / B / T / S J <br />LCJ SLIDES 8 DAMAGE ................... L Y / NA / ®/ R / V / B / T / S ] <br />LCJ SUBS IOENCE ........................ L Y / NA / ®/ R / V / B / 7 / S J <br />LCJ E%CESS SPOIL 8 DEVELOPMENT WASTE.. L Y / NA / ®/ R / V / B / T / S ] <br />LCJ OFFSITE SUPPORT FACILITIES........ L Y / ®/ N / R / V / B / T / S ] <br />LCJ RECLAMATION SUCCESS ............... L Y / NA / ®/ R / V / B / T / S ] <br />lCJ SPECIAL CATEGORIES OF MINING...... L Y / ~ / N / R / Y / B / T / S ] <br />(1) 120 <br />- - - - - - - - - - - - - - - - - - - - <br />(2) Spaces <br />(3) -------------------- Max] <br />- - - - - - - - - - - - - - - - - - - - <br />LCJ OTHERS......1....p .................. L Y / NA / N /tf / V / B / T ] <br />ll) ~c~C~LJ.`e-~~~ ------------- L20 <br />(2) Spaces <br />(3) -------------------- MaxJ <br />-------------------- <br />NOTE: LCJ =Required Entry. <br />