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<br />COAL BOND COMPLIANCE INSPECTION FORM <br />Mine //llhf l ~ jt,(? ~(,t!"yi~lts1 /"/y~ Permittee <br />Permit No. C ~-Q 71 Operator <br />Date /~-Z g-~( Inspector <br />~~>,~ ~ ~~ <br />Part 4 -Structures/Facilities -Completed at Permit Renewal and Midterm <br />1. List all structures, their composition, rough dimensions, and whether or not they are on <br />concrete foundations and/or footings. <br />Structure Dimensions Composition Foundation Footers <br />name or <br />purpose 1 X w X h steel, concrete, <br />cinder block, <br />wood, etc. yes/no <br />reinforced vs. <br />plain concrete yes/no <br />reinforced vs. <br />plain concrete <br /> <br /> <br /> o <br /> <br /> <br /> <br /> <br /> <br />