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so ptl6 p 319~J. S. DEPT. OF THE INfiERIOR (,~~ ~~ . <br />(j (r~i tJF,S[jIiFACE NIINING RECLAMATION AND ENFOftCIIYIIIV~'--,Q - tl~-~ -~ <br />'~MINERA~S i a=Site Eyaluafion Inspection Rei~at ~~~ ~~~~~~~~~~~~~ ~~~ <br />1.PetmitteeJPetson <br />irJ Ptues Nu S e L tl <br />2. Address <br />o Qo 65`1 <br />3. City 4. State <br />ao --i'Y Co <br />5. Zip Code 6. Phone Number <br />®-~... ~ l 9 -®- 3 9 <br />7.Operator if Differont than Permivee <br />8. Mine Name ' <br /> <br />9. Permit Number ]0. Type <br />a Pumit b. RA <br />C-g -05$ <br />11. Inspection Date 12. Itrspxtion Type 13. Joint Inspection <br />07^~ 4^® ® 0 »N <br />,rr no - rr <br />14. Permit Status 15. Site Status <br />I6. Facility Type <br />® HP <br />17.OSM l')ffict # 18. RSI # <br />D b t9. Land Code <br />?A. M.SJiA. ID # 21. State Code 22. County Code <br />05^ 19' ® o`t3 <br />?3. AVS Pemtittee'Prttity ID Number <br />1 .22 ~' <br />~, 24. Perfornlance Standard Categories 1! <br />es: l=Comuliance. Z=Noncomolinnee. S=Not Planned, 4„Not Started, 6=Noncompliance Tdenti5ed fleewhero 11 <br />Valid Permit <br />Bonded Area <br />6~Ttmtporary Cessation <br />B. Hydrologic Balance <br />1.~Dtatnage Control <br />2. ! Inspections & Certifications <br />3.LSiltation Structures <br />4. ~ Discharge Structura <br />& Grading <br />u~t Reclamation <br />>xrmate Onloaal Conmttr <br />Slopes (mctudes dovmslope) <br />ing of Acid & Toxic Materials <br />'vatton (rills and gullies) <br />E. Excess Spoil Disposal <br />1.~ Placemwt <br />2~Drainage Control <br />3. St¢face Stabt7izaGon <br />4.~inspations & Certifications <br />L Roads <br />1~3 RomdCoasnuction <br />2 3 Certification <br />3. <br />4,~Stnfacmg end Maintettance <br />5~ ?Rerlnmonnn <br />J. Sigtts & Markers <br />1. ~ Signs <br />2. ~ Markers <br />K. !Distance Prohibitions <br />L. Revegetation <br />- hVegetadveCover._-- -. ,..- - <br />V.~}...Y4YW LuW4l <br />7 Ground WateiMonimring _- <br />~ _ <br />F. Coal Mine Waste:... _ <br />(RefluePiles/Impo®dmmts) --- <br />SttrfaoeWaterMotGmring <br />8 <br />9~Drainage -Acid-Toxic M=tP^~ 1, i Drainage Control <br />10.! Impoundments 2,~Sttrface StabAr7ation <br />11.3StreatnBufftxZones 3.~Placement <br />4, i Inspecdons and Certifications <br />C. Topsoil & Subsoil 5.,~,Impoundtng Structures <br />1 3 Removal <br />3Substitute Materials <br />2 <br />G. Use OI Explosives <br />„ <br />3~LSmrage and Protection 1,~-Blasts Ctrtifieati°n <br />~'~e Prohibitions <br />2 <br />4~3 Redisttibudon .. <br />3.~.Blast Survey/Schedule <br /> 4.3Wamings & Records <br /> S.~Contral of Adverse Effects <br />Z5. Inspection Frequency 26. Inspection Hours <br />a~ a o 5 -®-® <br />trapedbn <br />®.®a Permit Renew <br />FYegneot~ for prcvbas 4 Calendar Qtrs. <br />hNamber of Nanbv or <br />amrytaa au(>auoat <br />~ ®.~ b. Ittspxtlon Timt e <br />mspoctioar caadoacd <br />~ r" Trove] Tune <br />e Number of Nambrr o[ <br />D g '~ ~ <br />O 1 ~~ d Report Writing <br />M. ~Postminiag Land Use <br />N. Other <br />~1)S~rALL AReA Exe~,tP7iox! <br />_2) <br />.7. Bonded Acres <br />a Taal <br />0 D .® bondee <br />~-1~-~-7~-''~'~~ b. Phan I <br />~-~-i-~. released <br />~.~a. PltaseII <br />tdeased <br />Phase III <br />released <br />28. Acres <br />'--"Y-~"'-~~~ aPCrmldSd <br />O O D ,~ h Disaabed <br />~~ <br />1 of <br />