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,. <br /> <br />/'~nT ~ n tQ:Q <br />III IIIIIIIIIIIII III <br />Pepe 1 0l } Papaa <br />. ...y Mlr:~~ ~~NC <br />United States Department of the L~M,~TiO~ 1 G1V SIGN For Office use Only <br />Office of Surface Mining <br /> <br />Mine Site Evaluation Inspection <br />Report ,a <br />~ ,b ,p <br />m m <br /> Y Y M M Bitch Report <br />' 10. Dale OI Inspection <br />2. Name of Permhtee 9. MSHA Number (Y Y M M D DI <br /> n r ~ J - ~ ~ - ., D U <br /> 3. Street Adtlrda 1t. Stale Permit Number <br /> 0 0 ~ _ a o I <br /> 4. City 5. Stale t2. Name of Mme <br /> <br />a <br />>t <br />+ <br />S <br />o <br />rt <br />~ <br />~ <br />I ~ i <br />, <br />~ <br />~ ~ <br />V ~ <br />I <br />I ~~ <br />I <br />6~Zmmlp'' C~~ooe 7. Area Cotle B. Telephone Number 13. County Code Jt~~4'fm~~Spta~~te Cooe 15 ^trala <br />W ~ ;~I16~~~SJI',a~~Ite Arca Onc~e <br />W <br />17. OSM Fieltl 16. OSM Area 19. OSM 20. Type of Inspection 21. Joint Inspection 22. Inspector's ID <br />Office No. Office No. Sample No. (}~('C''~oyde)~~~~ ~~~~~ y*Y~e~/sif~ No <br />L~7__J__L1_J /LX. ~ }N/o.~y~-~/~ <br />L1=1.1~ <br />' 23. Status 24. Type of Activity (check apP ncable dotes). <br />A ® Type of Permit <br />A ~ Sleep Slope <br />E ~ Anlnrac Re <br />B ~ Mine Status (Code} . <br />B ~ Mountain Top Removal <br />F ~ Federal Lands <br />C ~ Type of Facility (Code) <br />_ <br />C ^ Prime Fermlands <br />G O Intlian Lan^_s <br />D ~ D O • c7 Number of Permitlntl Acres <br /> D ~ Alluv,al Valley Floors H Other <br />E ~ Q 7J • Number of Disturbed Acres <br />25. Pertormance Sfangartls fCodesl <br />In•lruelionc Intllcate compliance cotle For any standard marketl 2 or 3 provide narrative to support lhls delerminati~n <br />Standards Thal Limit the Ellects [o the Permit Area <br />r Standards Tnat Assure Recramat:or. OualrtY and Timeliness <br />A ~ Distance Prohibitions ~ M ~ ToDSOiI Handl,ng <br />B © Mining Within Permit eountlaries N ~ Back!ilring ano Grading <br />C ~ Sipns antl Markers O ~ FcllowlnS Reclamation Scheonle <br />D ~ Sediment Cgntrol Measures P ~ Revegetabon Requiremens <br /> <br />E n Design and Certification Requirements- <br />kr-~ ''// <br />D ~ Disposal of Excess Spoil ~1'D GY~~S Car <br />Y <br />Sediment Control R © Handling of Acitl or Toxic Materials <br />F © Effluent Limits <br /> <br />G ~ Surface Water Monitoring <br />S ~ Highwall Ellminatton <br /> <br />H ~ Grountl Water Monllorinp T ~ Downslope SDOiI DISDOSaI <br /> <br />1 ~ Blasting Procetlures /Lo b~rLS-~~,n `( ` U ~ Post Mining Land Use <br />t V ~ Cessation of Operations: Temporary <br />J ~ HaullACCess Road Design antl Maintenance <br />` ,1 <br />K ® Refuse Impountlments GO t .5 R..Dr W ~ Other <br />L ~ Other: SDeclfy w4'~~ <br />Distribution: Original ~ Field Office, Green -Headquarters, Blue ~ State's Copy. Yellow -Inspector's Copy. Pink ~ File Copy IE - 763 (1187) <br />