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U. S. DEPT. OF THE INTERIOR <br />- OFFICE OF SURFACE MINING <br />Mine Site Evaluation State Program <br />Permittee\ CENTRAL APPALACHIAN Permit C-004-80 Field Visit 11/Ol/?005 Continuation Page <br />Person Number Date <br />29. Off-Site Impact Data and Identified Violation Data. <br />List all Ten-Day Notice actions and all Federal NOV or CO actions taken or reviewed during this current OSM site visit. List the <br />off-site impacts associated with either State or Federal actions taken during [his site visit. <br /> L. Off-Site Im acts <br />1. A. Specific State Law/Regulations Violated: Rule 4.05.3 (1) (e) <br /> P eo ple L d Water Str <br />c tures <br />B. Description: Failure [o maintain upland diversion culverts and a haul road culvert. <br />Blasting ~ u <br />C. Performance Standard BS D. Abated (Y/N) ~N Stability <br />E. OSM Action ~ F. OSM Action Number Viol.#^ Hydrology ~ ~ ~ IJ <br />G. Optional H. Any Off-Site Impacts Y/N ~N Encroachment <br />L Latitude °00'00" J. Longitude °00'00" K. Elevation ~ Other <br /> L. O ff-Site I m acts <br />2. A. Specific State Law/Regulations Violated: <br /> Pe o ple L nd W r Str <br />c tures <br />B. Description: <br />Blasting lu l a ~ u <br />C. Performance Standard ~ D. Abated (Y/N) ~ Stability <br />E. OSM Action ~ F. OSM Action Number Viol.#^ Hydrology ~ a <br />G. Op[iona! H. Any Off-Site Impacts Y/N ~ Encroachment <br />I. Latitude ~ J. Longitude ~ K. Elevation ~ Other <br /> L. Off-Site Im acts <br />3. A. Specific State T aw/Regulations Violated: <br /> Pe op le L n d W t er Stn t <br />et ures <br />B. Description: <br />Blasting a a ~ <br />C. Performance Standard ~ D. Abated (Y/N) ~ Stability <br />E. OSM Action ~ F. OSM Action Number VioL# ^ Hydrology <br />G. Optional II. Any Off-Site Impacts Y/N ~ Encroachment <br />I. Latitude ~ J. Longitude ~ K Elevation ~ Other <br /> L . Of f-S ite I m acts <br />4. A. Specific State Law/Regulations Violated: <br /> Pe op le L n d W t er Str ct ures <br />B. Description- <br />Blasting a a u <br />C. Performance Standard ~ D. Abated (Y/N) ~ Stability a <br />E. OSM Action ~ F. OSM Action Number Viol.# ^ Hydrology <br />G. Optional H. Any Off-Site Impacts Y/N ~ Encroachment a <br />L Latitude ~ J. Longitude ~ K Elevation ~ Other <br />OSNI Action Off-Site Lnpacts <br />For each type of impact and resource affected, enter <br />I) Deferred to State Action 5) [H-CO issued (Inuninem Lnvironmemal Harm) <br />" <br />N, D, or 1" to describe the degree of off-site impact: <br />2) TDN Issued 6) ID-CO Issued (Imminem Danger to PuhGc) <br />3) NOV Issued 7) Previously Cited by RA, Abatement Pending N -Minor Occurrence <br />4) FTA-CO Issued 8) Abated during or before OSM Inspection D -Moderate Occurrence page 3 of _ <br />9) Follow-up of Federal Action J - Major Occurrence Revised D~cr,ntxr a, tuns <br />