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For The Foll~.~ing Entries, Circle The Appropriate Choice: = nspec e an oun in co•np lance, NA = Inspection Topic not applicable, N Nit Inspected, R Ins Pected and Comments noted, Y = Inspected and Violations (NGY) or Cessation Order (CO1 issues, B = Inspected and both Comments noted 8 Violations or Cessation Order 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 / T / S LCJ S1GNS AND MARKERS ................. L~ / NA / N / R / V / B / T / S J LC1 ROADS ............................. L Y / NA / N /~R / V / B / T / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N /®/ V / B / T / S j LCJ BACKFILL 8 GRADING ................ L Y / NA / N / R / V / B / T / S ] LCJ EXPLOSIVES ........................ L Y / NA / N / R / V / B / T / S j LCJ PROCESSING WASTES ................. L Y / NA / N / R / V / B / T / S J LCJ SUPPORT FACILITIES ................ L Y / NA / N ~/ V / B / T / S LC] TOPSOIL ........................... Y / NA / N / R / V / B / T / S j LCJ GENERAL MINE PLAN COMPLIANCE...... Y / NA / N / R / V / B / T / S J ICJ FISH 8 WILDLIFE ................... Y / NA / N / R / V / B / T / S LCJ REVEGETATION ...................... L Y / NA / N / R / Y / B / T / S J LCJ AIR RESOURCE PROTECTION........... L ~ / NA / N / R / V / B / T / S LCj SLIDES 8 DAMAGE ................... L Y / NA / N / R / V / B / T / S j LCj SUBSIDENCE ........................ L Y / NA / N / R / V / B / T / S J LCJ EXCESS SPOIL 8 DEVELOPMENT WASTE.. L Y NA / N / R / V / B / T / S LCJ OFFSITE SUPPORT FACILITIES........ L Y / A/ N / R / V / B / T / S J LCJ RECLAMATION SUCCESS ............... L Y / NA N / R / V / B / T / S LCJ SPECIAL CATEGORIES OF MINING...... L Y NA / N / R / V / B / T / S J (1) l 20 (2) ---------- - - -- - - - - - - Spaces (3) ---------- - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - Max] lCJ . .................... . OTHERS..... . L Y / NA / N ~/ V / B / T J I ' ~-E ~ ~ ~ (1) ~~N ~ ~ L2 0 - (2) - - - - - - - - - S paces (3) ---------- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - MaxJ NOTE: LCJ = Required Entry.