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--r ~~ III IIII lilt iilll III <br />RECEIVEC3 P.a•tpl2 Vtp•, <br />United States Department of the Interior MINED Np For Ottice Use Only <br />Office of Surface Mining RECLAMATIO ! DI~{j5(ON , <br />, <br /> <br />Mine Site Evaluation Inspection <br />Report <br />~ p <br />p <br />~ m <br /> ' Y Y M M Batcn Repon <br /> t0. Dale of Inspection <br />2. Name of Permltte9 9. MSNA Numtmr (V V M M D D) <br /> r, - <br /> 3. Street Address ~ t1S ' .~^~. k A•4 ~A - Perm!t Numb <br />77. State <br />er <br /> <br />/~ <br />~ <br />i! <br />r <br />n <br />~ <br />~ ^ <br />L~ <br />I <br />~ / <br />1 _ <br /> ?7 I <br />4. City 5. 918te 12 n of Mina <br /> n ~: ,f - ~ ~ 4 . ~ ~,1 -,~ pl <br />ZID Code 7. Area Cotle 8. T¢lephone Number <br />6 13. Coumy Cooe 14. Slate Cooe <br />5. <br />~ <br />r <br />ats <br />t t6 <br />State Aroa 011!ce <br />/R~ <br />Vr~ ~ ~ ' <br />~ <br />;~~ <br />7I~ <br />t <br />n <br />I I <br />~ <br /> ~ <br />`L W <br />17. OSM Fleltl 1B. OSM Area 19. OSM Zp Type of Irspr_t!on 21. Joint InSD¢CIIOn 22. Inspector's ID <br />Oflice No. Otlice No. Sample No. <br />J (Cotlet vas No <br />~ No. <br />m ~ ~' G •} ~ ( v <br />Z3. Status 24. Type pl Activ!ty (check appl!cpble coxest. <br />A m TYPe of Permit <br />' ~ l <br />A U Sleep Slope <br />E ~ AnlhraC!Ie <br />B ~ Mine Status (Cotle) , <br />B ~ Mour!ta!n top Removal <br />F ~ <br />F <br />tl <br />l L <br />d <br /> ~ <br />o <br />¢ra <br />an <br />s <br />C ~ Type of Facility (Code) <br />C ~ Prime Farmlands _ <br />G <br />d <br /> ~ In <br />!an Lands <br />D /~ .~ ~ -r • Number 01 Permitletl Acres <br />D ^ Alluvial Valley Floors <br />H ~~ O <br />h <br /> <br />~ t <br />er <br />Y <br />r <br />E r r~ ~ .~ 7 • ..,~ Number of DlslurDetl Acres 1 <br />- <br />25. Performance S:antlartls ICOde51 <br />IntlNetlpnt: Ind!getP COmDIiBnce Cotle. For any slantlartl marketl 2 q! 3 prpvitle narrative to support In15 tleterm inalinn. <br />Standards That Limit the Fffects to the Parmrt Area Stantlartls That Assu•e ReU amahor. Ounlny ano Timeunecs <br />A ~ Drslande hrohiDitions M ~ TOp50il Handling <br />B 1^ Mining Within Permit BOUntlarie5 N ~ Bagkhlhn9 antl Gratlmg <br />C ~ Signs end Markers O ~ FDIIOwinp ReplamaDPn Schetlule <br />D © Sediment Control Measures P ~ Revepetation Requ nements <br />E ~ Design antl Cenitication Reou!rements- 0 ~ D!sposal pl Excess Spo!I <br />Sediment Control <br />R ~ Hantllinp pl Acrd or Toxic Materials <br /> <br />F ~ Effluent Llmlts <br />S ~ Hignwall EI!minalipn <br />G ~ Surtace water Monitoring <br />T ~ Downslope Spoil Disposal <br />H a Ground Water Monitoring <br /> U n Posl M!ninp Lantl Use <br />I ~ Blast!np Procedures I-F~ <br /> V ~ Ce55atiOn OI DOeratlOn S' TempOidry <br />J ~ HaullACCess Road Des!pn ano Maintenance <br /> W ~ Omer _ __ _ <br />K ~ Refuse Impoundments <br />L ~ Other: specify __ <br />Disv!but!on. Onginal ~ Feld Otl¢e. Green ~ Heatlpuaners, Blue ~ State's Copy. Yellow ~ Inspector's Copy Pmk.. File GppY IE ~ 163 It/B3r <br />