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For the Following Entries, Circle the Appropriate Choice: Y = Inspected and Found in Compliance NA = Inspection Topic Not Applicable N = Not Inspected R = Inspected and Comments Noted V = Inspected and Violations (NOV) or Cessation Order (CO) Issued B = Inspected and Both Comments Noted and Violations or Cessation Order Issued T =Ten-Day Notice Issued by OSM Oversight Personnel S = Sample Taken and Sent to the Lab for Analysis (Describe type and location of sample taken under Comment section.) GENERAL INSPECTION TOPICS: ICI AVAILABILITY OF RECORDS ............. ... Y / NA /~/ R / V / B / T / S ICl SIGNS AND MARKERS ................. ... Y / NA /O/ R / V / B / T / S fCl ROADS ........................... ... Y / NA / N ~/ V / B / T / S ICI HYDROLOGIC BALANCE ............... ... Y / NA / N /~ V / B / T / S [CI BACKFILL & GRADING ................. ... Y / NA ~ // N Y R / / V / B / T / S ICI EXPLOSIVES ........................ ... Y /iN- / N / R / V / B / T / S IC] PROCESSING WASTE ................. ... Y / NA / N / R / V ! B ! T / S ICI SUPPORT FACILITIES ................. ... Y A / N / R / V / B / T / S ICl TOPSOIL .......................... ... Y / NA /, N ! R / V / B / T / S ICI GENERAL MINE PLAN COMPLIANCE ....... ... Y ( NA N i R / V ( B / T / S [CI FISH & WILDLIFE ..................... ... Y / NA / N / R / V / B / T / S ICI REVEGETATION ..................... ... Y / NA / N / R / V / B / T / S ICI AIR RESOURCE PROTECTION ............ ... Y 1 NA / N / R / V ) B / T J 5 ICI SLIDES & DAMAGE .................... .. Y / NA / N /~/ V / B / T / S ICI SUBSIDENCE .... . ................... .. Y / ~A / N / R / V / B / T / S ICI EXCESS SPOIL & DEVELOPMENT WASTE ... .. Y / N A /~/ R / V / B / T / S ICI OFFSITE SUPPORT FACILITIES ............ .. Y ~~ -- ~~ /(NAJ ; N / R / V / B / T / S ICI RECLAMATION SUCCESS ............... .. Y / NA !'CN / R / V / B / T / S ICI SPECIAL CATEGORIES OF MINING ......... .. Y / IA~t+I ~~ / N / R / V / B / T / S (1) - - - - - - - - - - - - - - - - - - - - 121 - - - - - - -- - - - - - - - l3) - - - - - - - - - - - - - - - - - - - - - - - - - - ICI OTHERS ............................ .. Y / NA N / R / V / B / T 11) - - - - - - - - - - - - - - - - - 12) - - - - - - - - - - - - - - - - - - - - (31 - - - - - - - - - - - - - - - - - - - -