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For the Following Entries, Circ% the Appropriate Choice: Y = Inspected and Found in Compliance NA = Inspection Topic Not Applicable N = Not Inspected R = Inspected and Comments Moted V = Inspected and Violations (NOVI or Cessation Order [CO) Issued B = Inspected and Both Comments Noted and Violations or Cessation Order Issued T = Ten-Day Notice Issued by OSM Oversight Personnel S = Sample Taken and Sent to the Lab for Analysis (Describe type and location of sample taken under Comment section.) GENERAL INSPECTION TOPICS: [C] AVAILABILITY OF RECORDS ............. .. . Y / NA / ®/ R / V / B / T / S !CI SIGNS AND MARKERS ................. ... QY / NA / N / R / V / B / T / S [Cl ROADS ........................... ... Y / NA / N / ®/ V ! B / T / S IC] HYDROLOGIC BALANCE ............... ... V / NA / N /OR / V / B / T / S ICI BACKFILL & GRADING ................. .. . ~/ NA / N / R / V / B / T / S [C] EXPLOSIVES ........................ ... Y / ® / N / R / V / B / T / S [C] PROCESSING WASTE ................. ... Y / NA / ®/ R / V / B / T / S [CI SUPPORT FACILITIES ................. ... Y / NA /ON / R / V / B / T / S IC] TOPSOIL .......................... ... Y / NA / N /~/ V / B / T / S [C] GENERAL MINE PLAN COMPLIANCE ....... ... Y / NA / ®/ R / V / B / T / S ICl FISH & WILDLIFE ..................... ... ©/ NA / N / R / V / B / T / S (C] REVEGETATION ..................... ... Y / NA / N / ®/ V / B / T / S [CI AIR RESOURCE PROTECTION ............ ... ®/ NA / N / R / V / B / T / S ICI SLIDES & DAMAGE ................... ... ~ / NA / N / R / V / B / T / S [Cl SUBSIDENCE ....................... ... Y / NA /o / R / V / B / T / S [C] EXCESS SPOIL & DEVELOPMENT WASTE ... ... Y / NA /ON / R / V / B / T / S fCl OFFSITE SUPPORT FACILITIES ........... ... Y / NA / ©/ R / V / B / T / S [Cl RECLAMATION SUCCESS .............. ... Y ! NA / ~ / R ! V ( B f T ( S [CI SPECIAL CATEGORIES OF MINING ........ ... Y / ® / N / R / V / B / T / S (1) - - - - - - - - - - - - - - - - - - - - (2) - - - - - - - - - - - - - - - - - - - - (31 - - - - - - - - - - - - - - - - - - - - [CI OTHERS ........................... ... Y / ®/ N / R / V / B / T 11) - - - - - - - - - - - - - - - - (2) - - - - - - - - - - - - - - - - (3) - - - - - - - - - - - - - - - - - - - -