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For The Foll,,,i~ig Entries, Circle The ADDrooriate Choice; = nSpe.: e do OUn In CO~np lance, - NA = Inspection Topic not applicable, N Nit Inspected, R =Inspected and Comments noted, Y =Inspected and Violations (NOV) or Cessation Order (CO) issued, B = Inspected and both Comments noted 8 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 and location of sample taken under comment section. GENERAL INSPECTION TOPICS: CORDS........... L Y / NA / N / ®/ V / B / 'i / S LCJ SIGNS AND MARKERS ................. L Y / NA / N / ®/ Y / B / 'i / S I LCJ ROADS ............................. L Y / NA / N / ®/ V / B / 'i / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N / ~' V / 8 / 'i / S J LCJ BACKFILL 8 GRADING ................ L Y / ~/ N / R / V / B / 'i / S J lC7 EXPLOSIVES ........................ L Y / ~/ N / R / V / B / 'i / S J LCJ PROCESSING WASTES ................. L Y / NA / N / ~/ Y / B / 'i / S J lCJ SUPPORT FACILITIES ................ L Y / NA / N / ®/ V / B / 'i / S J LCJ TOPSOIL ........................... L Y / NA / N / ®/ V / B / 'i / S 1 LCJ GENERAL MINE PLAN COMPLIANCE...... L Q/ NA / N / R / V / B / 'i / S LCJ FISH 8 WILDLIFE ................... L ®/ NA / N / R / V / B / 'i / S J LCJ REVEGETATION ...................... L ~/ NA / N / R / V / B / ~i / S ] LCJ AIR RESOURCE PROTECTION........... L ~/ NA / N / R / V / B / i / S J lCJ SLIDES 8 DAMAGE ................... L Y / ® / N / R / V / B / 'i / S LCJ SUBSIDENCE ........................ L ©/ NA / N / R / V / B / i / S LCJ EXCESS SPOIL 8 DEVELOPMENT WASTE.. l Y / J~A / N / R / Y / B / i / S ] LCJ OFFSITE SUPPORT FACILITIES........ L Y / NA / N / ® / V / B / i / S J lCJ RECLAMATION SUCCESS ............... L O / NA / N / R / V / B / 'i / S ] LCJ SPECIAL CATEGORIES OF MINING...... ! Y / ®/ N / R / V / B / 'i / S J (2j -------------------- L2SDeces (3) -------------------- MaxJ - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y/ NA / N /~/ V/ B/ T J (2j ~_ ~ ~_ ~ - k ~ ~ ~ LZ ~- - - - - - ' - -_ LSDeces (3) --------------------- MaxJ NOTE: LCJ = Required Entry.