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For the Foll~,nng Entries, Circle The Appropriate Choice: = nspec e an pun in Comp lance, NA = Inspection Topic not applica~le, N = Nit Inspected, R = Inspected and Comments noted, V = Inspected and Violations (NOV) or Cessation Order (C0) issued, B = Inspected and both Comments noted 8 Violations or Cessation Order issued, T = 10 Day Notice Issued by OSM Oversight Personnel, S =Sample taken and sent to the lab from analysis - describe type and location of sample taken under co rnnent section. GENERAL INSPECTION TOPICS: CORDS........... L Y / NA/ N /~/ V / g / T / S ] LC1 SIGNS AND MARKERS ................. L Y / NA / N /~/ V / B / T / S j LC1 ROADS ............................. L Y / NA / N /®/ V / B / 7 / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N /~/ V / B / T / S j LCJ BACKFILL 8 GRADING ................ L Y / NA / N / R / V / B / T / S ] LCJ EXPLOSIVES ........................ L ~/ NA / N / R / V / B / T / S J LCJ PROCESSING WASTES ................. L Y / N,4 / N / R / V / B / T / S .1 LCJ SUPPORT FACILITIES ................ L Y / NA / N / GR / V / B / T / S ] LCJ TOPSOIL ........................... L Y / NA / N /~/ V / B / T / S J LCJ GENERAL MINE PLAN COMPLIANCE.,,.,, L~Y / NA / N / R / V / B / T / S J LCJ FISH & WILDLIFE ................... L Y / NA / N /~ V / B / T / S ] LCJ REVEGETATION ...................... L Y / IA / N / R/ V / B / T / S J LCJ AIR RESOURCE PROTECTION........... L ~/ NA / N / R / V / B / T / S ] lC] SLIDES 8 DAMAGE ................... L ®/ NA / N / R / V / B / T / S ] LCJ SUBSIDENCE ........................ L ©/ NA / N / R / Y / B / 7 / 5 J LCJ EXCESS SPOIL 8 DEVELOPMENT WASTE.. L Y / ®'/ N / R / V / B / T / S ] LCJ OFFSITE SUPPORT FACILITIES........ L Y / ®/ N / R / V / B / T / S ] LC1 RECLAMATION SUCCESS ............... L Y / (~J~'/ N / R / V / B / T / S ] LCJ SPECIAL CATEGORIES OF MINING...... L Y / ®/ N / R / V / 8 / T / S ] (1 ) L20 (2) -------------------- Spaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y / NA / N / R / V / B / T ) (1) L20 (2) -------------------= Spaces (3) -------------------- MaxJ - - - - - - - - - - - - - - - - - - - - NOTE: LC] = Required Entry.