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- - Yr ~(, <br />~~ 1 yam. 1 ~ _ . ~ ly7~ <br />~.: . <br />~' <br />~~ : + ~~ r ~ ~~ ~ ~ G ~~ III IIIIIIIIIIIII Ill <br />- :r," =~9~fr ~ ~ .. ~~ ~ ~. - ~ ,. 999_ - -- <br />.r',x-' United States Department of the Interf~pR 27 ~g89 For Office Use Only <br />-•.`~ -s; ~ ~~°. ~ "'s' Office of Surface Mining ....... - . -. 1...-.; :. . ' ,n . ` _ ,e .. <br />';,;=; : ; . Mine Site Evaluation, Inspection RepdYlINED LHND <br />_ '- : _ ~:. °', ~ - •_ _ DECLAMATION DIVI ION ,. m m <br /> <br />2. Name o1 Permlttee .,.., ~;, . ..~..t.. ~, ,` o< <br />. ~ :':: Y,". +,..:P,_ ±, . _ _ <br />"•k~ ~:. ~ • = <br />9. MSMA Number . ~ .. , 10. Date of Inspection <br />(Y Y M M D D) <br /> 7 <br />3. Str•et Atltlreee ~ ~ ~ ~ ~ ~ r - ~ •~ 11. State Permit Number <br /> x ' L ~ :. ' - o i l BS I <br />- a. City ' " 5. State <br />~ t2. Name of Mine ~ ~ ' <br />~' <br /> ^ r .: <br />',' <br />8. Zlp C <br />de `- 7. Area Code B. Telephone Number 13. County Cotle 14. <br />ate Cotle ~ 15. Strata 16 Slate Area Office <br /> [i ~ e <br />~ ~ L'J ~ .. ~ l ~ ' S <br />~°J m ° ~ <br /> <br />- 17. OSM Field 18. OSM Area - 19. OSM ~ 20. Type pl Inspection 21. Joint Inspection 22. Inspector's ID <br />tf <br />l <br />NO. Office No. <br />O <br />c <br />e Sample No. (Code) Yes No N <br />o. <br />m~ <br />~j <br />/, <br />f` <br />~~ <br />~ d~ ~~` <br />~ ~ <br />~~, ~~ +-/~~~ <br /> <br />23. Status ~ 24. Type of Activity (check applicable oozes). <br />A O ~ TyPa of Permll <br />_ ~T--1 <br />S I / y I ~ <br />Mina Status (Code) A ~ Steep Slope E ~ Anthracite <br />.yaJ B ~ Mouruain Top Removal F ~ Fetleral Lantls <br />C ~ Type of Feclllty (Code) <br /> C ~ Prime Farmlands G ~ Indian Lands <br />D (~ ~ (~ • Number of Permittetl Acres <br /> D ^ Alluvial Valley Floors H ^ Other <br />E p (.~ (~ • ~, Number of Disturbetl Acres <br /> 25. Performance Stantlartls fCotlesl <br />' In•truetlonc Intllcate compliance Cotle. For any standard merketl 2 or 3 Droritle narrative In support this determination. <br />Standards That Limit the Effects to tiro Penult Area Standards That Assure Reclamation Quality and Timeliness <br />A ~ Dlstenge PrOhlbitions ~ M ~ Topsoil Handling <br />B © Mining Within Permll Boundaries ' ' - N 1^ BacMilrrng end Gradmg ~ - ~ - - <br />C ~ Signs antl Markers O ~ Following Reclamation Schetl~ile <br />D O Sediment Control Meewraa ~ ~ P ~ Reregeution Requirements ._ _ <br />xE <br />` © Design end Certlllcallan Requirements- _ _ O ~ Disposal of Excess Spoil <br />- <br /> <br />~•F Sediment Control <br />_ <br />~ Effluent Llmtts ~ ~ <br />R _ <br />© Hantlling of Acid or Toxic Materiah <br />~ - <br />_- 5 ~ Highwall Elimination <br />- G /^ SuAece Water Monltoring ~ .. <br />- <br />T <br />~ Down5loDe SDOII Disposal <br />H /~ Grountl Water Monltorinp ' <br />U <br />~ Post Mining Land Use <br />1 ~ Bleating Procetlurtp ." _ - <br /> V ~ Cessation of Operations: Temporary <br />J ~ HeullACCese Roatl Design and Maintenance <br /> <br />G <br />a <br />~ <br />'} ~ <br />W <br />~ Other <br />. , K o n- <br />[6 <br />~ Reluse Impountlments <br />Ao <br />L ~ Other. Spaclty <br />Dletrlbutlon: Original ~ Field Olllce, Green ~ Headquarters, Blue ~ State's Copy. Y¢Ilow ~ Inspector's Copy, Pink ~ File Copy IE - 163111&3) <br />