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• •~ ~,~ <br />-- ~ Pave 1 of t PaOea <br />~„• ra. ®a a ~ cam Cam. <br />United States Department of the Interiol~E~ 17 ~g$7 For Office Use Only <br />Office of Surface Mining <br /> <br />Mine Site Evaluation Inspection <br />ReportMllJED LANG ,a ,b ,D <br /> RECLAMATlCN 7iV SIO~ m m <br /> Y Y M M BarcD Report <br /> 10. Dale of Inspection <br />2. Name of Permitlee 9. MSHA Number (Y Y M M D D~ <br /> c >, p p ~z c m t >J t rJ ~ o ~ - o z s - 7i~oz <br /> 3. Street AdtlreS9 11. State Permit Number <br /> g o o x I S ? c - o / o - s l <br />4. City 5. Slate 12. Name of Mine <br /> <br /> C c ~. ~ ~ t• a, p per <br />8. Zlp Code 7. Area Code B. Telephone Number 13. County Code 16 State Code 15. Strata 16. Slate Aroa Of1lce <br />$t taz~ 303 8 <~-~~o/ os1 0~ m <br />17. OSM Fieltl 18. OSM Area 19. OSM 20. Type of InsDeclion 21. Joint InsDeclion 22. Inspector's ID <br />Ofllce No. Olllce No. Sample No. <br />3S` (Code) ~YeX~s Nno No. <br />(~ 7 <br />Z <br />OZ ~ ~ LJ L! <br />23. Status 24. Type of Activity (check applicable oozed. <br />A ~ Type of Permit <br />A ~ Steep Slope <br />E ~ Anmracite <br />8 ® Mlne Status (Code) <br />B ~ Mourllain Top Removal ~ <br />F L~l FRtleral Lentls <br />C f p Type of Facility (Code) <br />C ~ Prime Farmlantls <br />G ~ Indian Lentls <br />D ( " S r>' • ,~ Number of Permiltetl Acres <br /> D ~ Alluvial Valley Floors H ~ Other <br />E Q Z (~ ~(b • / Number of Dlsturbetl Acres <br />25. Performance Standards fCotlesl <br />In•truetbnc Intllcete comDllance code. For any stantlartl marked 2 or 3 provide narrative to support this determination. <br />Stantlarda That Llmlt the Ellects to the Permit Area Standards Thal Assure Reclamation Ouallly and Timeliness <br />A ~ Distance Prohlblllons M ~1 Topsoil Handling <br />B ~ Mlninq Wlthln Permit 6oundarles ~ N ~ Backfill~ng and Grading <br />C ~ Signs entl Markers O ~ Following Reclamation Sc11etl~Ile <br />D ~ Sediment Control Measures P ~ Revegetahon Requirements <br />E a Deelgn entl Certlflca[lon Requirements- O ~ Disposal of Ezcess SDOII <br />Sediment Control <br />R ~ Hantllinq of Acid or Tozic Materials <br />F © Effluent Llmlte <br />5 ~ Hlghwall Elimination <br />G ~ Surface Water Monltorlnq <br /> T ~ Downslope Spoil Disposal <br />H a Grountl Water Monltorlnp <br /> U ~ Post Mining Lantl Use <br />I ~ Blsstlnp Procedures <br />V ~ Cessation of ODerallons: Temporary <br />J ~ Haul/Access Roatl Deelgn and Maintenance <br /> <br />K ~ Refuse Impoundments w ~ Other <br />L ~ Other. SDecHy <br />e <br />Dlstrlbullon: Original -Field Olllce, Green ~ Headquarters. Blue ~ State's Copy. Yellow ~ Inspector's Copy. Pink ~ File Copy IE - 11i3 (1/83( <br />