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F' <br />Pepe 2 01 Z Pepee <br />-~ Uli(tediStates'Oepartment of the Interior ~~ ' <br />- Office of Surface Mining ~j <br />~ <br /> Mine Site Evaluation Inspection fleport - <br />`-•- <br /> ~ <br />Zs. State Pamrit Number - 27. Oate of InsDectlon <br /> YMMDD) <br />,- / - O O <br />2B. YM No Do mining and:reclamation activities on the site comply with the plans in th permit? <br />^ It no, ride nartatlve to au ort his determination. <br />Z9.1nWCaro taarfber of complete and partial Inspe ions conducted by the State to date for this annual review period: <br />29a m Number of Completes 29b. m Number of Partials <br />30. Indicate MaffbM of complete and partial Inspections required by the State during this annual review period: <br />30a m Number of Completes 30b. m Number of Partials ~~~~ <br />31. Has Mrpecticn (reyuerfcy been met? . <br />Yes No Yes No <br />31a ^ ^ Comgtetea 31 b. Partials <br />32. FEDERAL FJiFORCE1r1ENT INFORMATION. IEntar violation number. eck apprdpriate box(es)] <br />TefrDSy Ndice Ho. Notice of Violation Nfl. Cessation Order Violation Codes <br />. ' <br />~~ <br />A~ ^ ~ <br />~ ~ ,. Authorizatlons 10 Operate <br />9 ^ ..................... ^ ...... ............... ^ .... ...:.:.:.~~...=~ Signs and MarkerS^.'... <br />....... <br />C . <br />Backfllling and Gredlrlg <br />D^ ^ ~'. - ~ ~ :: Hlphwall Ellminatlon. <br />' <br />E ^ ..................... ^ ...... ............... ^ .... .....':...~ Rills and Gulllea ` .. :~, <br />.......... <br />F ~ , <br />Improper Fills ''• <br />C'^ ..................... ^ ...... ............... ^ .... ......:............. Topsoil Handllnp <br />H^ •----• ............... ~ ^ ....~.. ............... ^ .... ..............:,,... Sediment Ponds <br /> <br />I ^ ............. _....... <br />^ ...... <br />................ ^ .... . :. <br />........:........... Effluent Llmlts <br />~ ^ .. ................... ^ ...... ....:.......... ^ .... ............... r.... Water Monltorinp <br />K ^ ^ - ^ ~ - ~ ~ ~ Buffer Zones <br />~ <br />- <br />............'........ <br />L^ ..................... ...... <br />^ ... <br />... ................ .... <br />...-........... ^ .... ........... F-... <br />.-.. <br />................:~... Roads <br /> , <br /> <br />N^ ..................... ^ .....- ,.............. ^ ..~.. ............; ... Blasting <br />.... <br />O^ ^ ~ ^ " Revegetatlon <br />P ^ ^ ^ ' = Spoil on the Downslop0 <br />O^ <br />'..' ................. ^ <br />..x ... ^ <br />............... .... ,Mining Without Permit <br />.............~..:... <br />R^ ...---' .............. ^ ...... ............... ^ .... .................... Exceeding Permit Wmits <br />S ^ ^ ^ Distance Prohibitions <br />T ^ ^ ^ .... .................... Toxic Materials <br />V ^ ..................... ^ .:.... ............... ^ .... .................... Other Violations <br />33. Name of Authfaiud ftepr ntative (print or type) <br /> <br /> <br />Signature t Augrorimd Representative Date O s ~ <br />r` / / D O <br />Signature of ~atirerinq Official Date U ~ O <br /> Z o <br /> o . <br />•"~ <br />i„ _'.., <br />pialriWfion.dipinal -Field Ofllce, Green - Heart~uad Blpe - Sta(etsRgpy.Y8110iv -Inspector's Copy, Plnk=File Gopy=~ • ~" ~,tBiY <br />