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<br />For The Following Entries. Circle The Approrpiate Choice: <br />r = inspectea anq rouna in compliance, <br />NA = Inspection Topic not applicable, <br />N =Not Inspected, <br />R =Inspected and Comments noted, <br />V =Inspected and Violations (NOV) or Cessation Order (CO) issued, <br />B =Inspected and both Comments noted & Violations or Cessation <br />Order issued, <br />T = 10 Day Notice Issued by OSM Oversight Personnel, <br />S =Sample taken and sent to the lab from analysis -describe <br />type and location of sample taken under comment section. <br />GENERAL INSPECTION TOPICS: <br />C AVAILABIL TY 0 RECORDS........... [ Y / NA / ~/ R / V / B / T / S ] <br />[C] SIGNS AND MARKERS ................. (~/ NA / N / R / V / B / T / S ] <br />[C] ROADS ............................. [ 0 / NA / N / RR / V / B / T / S ] <br />[C] HYDROLOGIC BALANCE ................ [ Y / NA ll <br />/ N /ttY / V / B / T / S ] <br />[C] BACKFILL & GRADING ................ [ Y / NA / N / f~l / V / B / T / S ] <br />[C] EXPLOSIVES ........................ [ Y / NA /(1~/ R / V / B / T / S ] <br />[C] PROCESSING WASTES ................. [ Y / NA / (~ / R / V / B / T / S ] <br />[C] SUPPORT FACILITIES ................ [ Y / NA /~/ R / V / B / T / S ] <br />[C] TOPSOIL ........................... [ Y / NA / N /(®/ V / B / T / S ] <br />[C] GENERAL MINE PLAN COMPLIANCE...... [ Y / NA /(~/ R / V / B / T / S ] <br />[C] FISH & WILDLIFE ................... [ YC7/ NA / N / R / V / B / T / S ] <br />[C] REVEGETATION ...................... [ Y / NA / N / ~/ V / B / T / S ] <br />[C] AIR RESOURCE PROTECTION........... [ ©/ NA / N / R / V / B / T / S ] <br />[C] SLIDES & DAMAGE ................... [ Y / NA / G~ / R / V / B / T / S ] <br />[C] SUBSIDENCE ........................ [ Y / ~ / N / R / V / B / T / S ] <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE.. [ Y / A <br />N / ~/ R / V / B / T / S ] <br />[C] OFFSITE SUPPORT FACILITIES........ [ Y / S <br />~ / N / R / V / B / T / S ] <br />[C] RECLAMATION SUCCESS ............... [ Y / NA / ~ / R / V / B / T / S ] <br />[C] SPECIAL CATEGORIES OF MINING...... [ Y / '~ / N / R / V / B / T / S ] <br />(1) -------------------- [20 <br />~3~ -------------------- Spaces <br />- - - - - - - - - - - - - - - - - - - - Max] <br />[C] OTHERS ............................ [ Y /~L~ / N / R / V / B / T ] <br />(1) -------------------- [20 <br />____________________ Spaces <br />(3) -------------------- Max] <br />NOTE: [C] = Required Entry. <br />