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For The -~ NA N R Y B T S Following Entries, Circle The Appropriate Choice: nspec a an oun in comp lance, Inspection Topic not applicable, Not Inspected, Inspected and Comments noted, Inspected and Violations (NOV) or Cessation Order (CO) issued, Inspected and both Comments noted & Violations or Cessation Order issued, 10 Day Notice Issued by OSM Oversight Personnel, Sample taken and sent to the lab from analysis - describe type ana location of sample taken under comment section. GENERAL INSPECTION TOPICS: CORDS........... L Y/ NA /~/ R/ V/ B/ T/ S J LCJ SIGNS AND MARKERS ................. L Y / NA / N / / V / B / T / S ] LCJ ROADS ............................. L Y / NA / N / / Y / B / T / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N / / V / B / T / S LCJ BACKFILL & GRADING ................ L Y / NA /~/ R / V / B / T / S LCJ EXPLOSIVES ........................ L Y / NA / N / R / V / B / T / S LCJ PROCESSING WASTES ................. L Y/ A/ N/ R/ V/ B/ T/ S J LCJ SUPPORT FACILITIES ................ L Y / NA / N / R / V / B / T / S Lr_] TOPSOIL ........................... L Y / NA / N / R / V / B / T / S LCJ GENERAL MINE PLAN COMPLIANCE,.,,,, L Y / NA / N [~/ V / B / T / S ] LCJ FISH & WILDLIFE ................... L Y / NA / ~/ R / V / B / T / S 1 LCJ REVEGETATION ...................... L Y/ NA J N /~/ 4/ 6 1 T! S] LCJ AIR RESOURCE PROTECTION........... L Y / NA /~t%/ R / V / B / T / S J LCJ SLIDES 8 DAMAGE ................... L Y / NA / N /~/ V / B / T / S LCJ SUBSIDENCE ........................ L Y/ A/ N/ R/ Y/ B/ T/ S LCJ EXCESS SPOIL & DEVELOPMENT WASTE.. L Y / A / N / R / V / B / T / S LCJ OFFSITE SUPPORT FACILITIES........ L Y / NA / C/ R / V / B / T / S LCJ RECLAMATION SUCCESS ............... L Y / NA / N / C/ V / B / T / S ] LCJ SPECIAL CATEGORIES OF MINING...... L Y / NA /~/ R / V / B / T / S (2j ~Z~ £ ~--.~~ c~ P =-~u1LJL~~-- LZSpaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - LC] OTHERS ............................ L Y/ NA / N/ R 1 V 1 B/ T J ~pj -------------------- LSpaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - NOTE: LCJ = Required Entry.