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For The Following Entries, Circle The Appropriate Choice: = nspec a an oun to comp Lance, NA = Inspection Topic not applicable, N =Not Inspected, R =Inspected and Comments noted, V =Inspected and Violations (NOV) or Cessation Order (CO) issued, B =Inspected and both Comments noted & 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 o.f sample taken under comment section. GENERAL INSPECTION TOPICS: CORDS........... L~/ NA / N / R / Y / B / T / S ] LCJ SIGNS AND MARKERS ................. L~/ NA / N / R / V / B / T / S 1 LCJ ROADS ............................. L Y/ NA / N ~/ V / B / T / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N ~/ V / 8 / 7 / S LCJ BACKFILL & GRADING ................ L Y ~ / N / R / V / B / T / S LCJ EXPLOSIVES ........................ L Y ~/ N / R / V / B / T / S J L~:J PROCESSING WASTES ................. L©/ NA / N / R / V / B / T / S LCJ SUPPORT FACILITIES ................ L Y / NA / N /~ / Y / 8 / T / S J LCJ TOPSOIL ........................... L~/ NA / N / R / V / B / T / S J LCJ GENERAL MINE PLAN COMPLIANCE...... L ©/ NA / N / R / V / B / T / S ] LCJ FISH & WILDLIFE ................... L®/ NA / N / R / V / B / T / S J LC] REVEGETATION ...................... L~/ NA / N / R / V / B / T / S J LCJ AIR RESOURCE PROTECTION........... L Y / NA / N /~/ V / 8 / T / S J LCJ SLIDES & DAMAGE ................... L Y ,~' N / R / V / B / T / S LCJ SUBSIDENCE ........................ L®/ NA / N / R / V / B / T / S LCJ EXCESS SPOIL & DEVELOPMENT WASTE.. L~/ NA / N / R / V / 8 / T / S LCJ OFFSITE SUPPORT FACILITIES........ L Y /~ N / R / V / B / T / S ] LCJ RECLAMATION SUCCESS ............... L©/ NA / N / R / V / B / T / S ] LCJ SPECIAL CATEGORIES OF MINING...... L Y /~ / N / R / Y / B / T / S ] (1) L20 - - - - - - - - - - - - - - - - - - - - (2) Spaces (3) -------------------- Max] -------------------- LCJ OTHERS ............................ L Y / NA / N /®/ Y / B / T ] (zj ~o.a~ge.~sS~------------- L2o Spaces (3) -------------------- Max) NOTE: LCJ = Required Entry.