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Pape Z of 2 Pepee <br />_ <br />United States Department of the Interior d <br /> Office of Surface Mining' <br /> Mine Site Evaluation Inspection Report <br />26. State Permit Number 27. Date of Inspection <br /> (YYMMDD) <br /> <br />28. 'Yes No Do mining and reclamation activities on the site comply with the plans In the permit? <br />l7 ^ If no, rovlde narrative to su oA this determination. <br />29. Indicate number of complete and partial inspections conducted by the State to date for this annual review period: <br />29a. ~ Number of Completes 29b. :~ Number of Partials <br />30. Indicate number 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 Inspection frequency been met? <br />Yes No Yes No <br />31a. ^ ^ Completes 31b. ^ ^ Partials <br />32. FEDERAL ENFORCEMENT INFORMATION. [Enter violation number. Check appropriate box(es)[ <br />Ten•Day Notice No. Notice of Violation No. Cessation Order No. Violation Codes <br />A ^ ^ ^ Authorizations to Operate <br />8 ^ ^ ^ Signs and Markers <br />C ^ .~ .................... ^ ....... .............. ^ ........................ Backfllling and Grading <br />D ^ ..................... ^ ....... .............. ^ ........................ Hlghwall Elimination <br />E ^ ..................... ^ ....... .............. ^ ........................ Rills antl Gullies <br />F ^ ..................... ^ ....... .............. ^ ....................~.... Improper Fills <br />G ^ ..................... ^ ....... .............. ^ ........................ Topsoil Handling <br />H ^ ^ ^ Sediment Ponds <br />I ^ ..................... ^ ....... .............. ^ ........................ E111uent Llmlts <br />J ^ ^ ^ Water Monitoring <br />K ^ ^ ^ •.........••...•........ Buffer Zones <br />L ^ ..................... ^ ....... .............. ^ ........................ Roads <br />M ^ ..................... ^ ....... .............. ^ ........................ Dams <br />N ^ ..................... .^ ....... .............. ^ ........................ Blasting <br />0 ^ ...••.......••..•.... ^ ^ Revegetation <br />P ^ ..... ................ ^ ....... .............. ^ ........................ Spoil on the Downslope <br />O ^ ^ ^ .•.•.....••••.....••.... Mining Without Permit <br />R ^ ^ ~ ^ Exceeding Permit Limits <br />S ^ ^ ^ Distance Prohibitions ' <br />T ^ ^ ^ Toxic Materials <br />~ ^ ..................... <br />....... <br />^ ^ ........................ <br />.............. Otner Violations <br />33. Name of Authorized Representative (print or type) <br />~~ <br />Signature of Authorized Representative - Date - ~~ <br /> ~ - ~ is <br />Signature of Reviewing Otllcial _ •, Date : •~ ~° ~, <br /> + <br /> ~ <br />Dislricutlon: Original -Field Olllce, Green ~ Heatlquarters, Blue - Stata'e Copy. Yellow -Inspector's Copy, Pink ~ File Copy IE - 163 (1783) <br />