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For The Foll~.,~~ig Entries, Circle The Appropriata Choice: = ns p?:, a do Oun In comp 1dnCe, NA = Inspac[ion Topic not aDPlica:~1~, N Nit inspected, R Inspected and Comments noted, Y =Inspected and Violations (JOV) dr Cessation Order (CO1 issued, B = Inspected and both Comments noted 8 Violations or Cessation Grder issued, T 10 Day Notice Issued by GSM Oversight personnel, 5 =Sample taken and sent to the lab from analysis - describe type and location of sample taken under comment section. GENERAL INSPECTION TOPICS: CORDS........... I Y/ NA i / R/ V/ B/ T/ S J LC1 SIGNS AND MARKERS ................. L Y / NA / / R / V / B / T / S J LCJ ROADS ............................. L Y / NA / N / / V / B / T / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N / / v / a / r i t .~ LCJ BACKFILL 8 GRADING ................ L Y / NA / ~ / R / V / B / T / $ J LC] EXPLOSIVES ........................ L Y / NA / / R / Y / 8 / T / S J L~=J PROCESSING MASTES ................. L Y / NA / N / Q / V / B / T / S ] lCJ SUPPORT FACILITIES ................ L Y / NA / N / R / V / B / T / S ] l~1 TOPSOIL ........................... L Y / NA / N / R / V / 8 / T / S ] LCJ GENERAL MINE PLAN COMPLIANCE...... L Y / NA / N / R / V / B / T / $ J LCJ FISH d NILDLIFE ................... L Y / NA / N / R / Y / B / 7 / S ] LCJ REVEGETATION ...................... L Y / NA / N /~/ V / B / T / S LGJ AIR RESOURCE PROTECTION........... L Y / NA / / R / Y / B / T / S J LCj SLIDES b DAMAGE ................... L Y / NA / N / R / V / B / T / S LCJ SUBSIDENCE ........................ L Y / NA / N / R / Y / B / T / S J LCJ EXCESS SPOIL b DEVELOPMENT NASTE.. l Y / NA / N / R / V / B / T / S ] LC] OFFSITE SUPPORT FACILITIES........ l Y / HA / N / R / V / B / T / S ] LCJ RECLAMATION SUCCESS ............... l Y / NA / N / R / V / B / T / S ] LCJ SPECIAL CATEGORIES OF MINING...... ! Y / NA / N / R / V / B / T / 5 J (1) L20 (2) -------------------- Spaces (3) -------------------- Max] -------------------- lCJ OTHERS ............................ L Y/ NA / N /~/ V/ B/ T J (2j ~J211~-~~~ ~5~--------- L20 ____________________ Spaces (3) -------------------- MaxJ NOTE: lCJ RequlreG Entry.