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~' ;5 r~ • i <br />/~ q q y+~y Pepe 1 or Z Pagee <br />nfJ ~ {I a ~ '~i a® ~ ~J AI <br /> <br />United States Department of the I nterior OCT 2 G 19 For Offic e Use Only <br />Office of Surface Mining <br /> <br />Mine Site Evaluation Inspection <br />_ <br />Report MINED W <br />f~ECL6MATiON D ,a <br /> <br />VIS~ ,b ,q <br /> Y Y M IA Ba1Cn Repon <br /> t0. Dale of Inspection <br />2. Name of Permlttee g. MSHA Number (Y Y M M D D) <br /> ' <br />~n <br />N <br />~ <br />u <br />~~ <br />i'~ <br />f! <br />1 <br />w <br />~ <br />c <br />C <br />~ c <br />R <br />'~ <br />- <br />-I'7 <br />~ <br />i <br />- J r <br />~ 7 / 3 <br /> 3. Street Address 71. State Permit Number <br /> f' '~ ~ 9 K - J _ ~ t 1 $ I. <br />4. City 5. Stale t2. Name of Mine <br /> ~ _ :~ ~ x z : ~ ~o ~p .~ ~,a 1~1~ I ~ 1 1 <br />I ~ I I I I I 1 1 1 1 <br />6. Zip Code 7. Area Catle 8. Telephone Number 13. County Code t4 Slate Code 16. Strata t6. Slate Aroa Office <br /> <br />17. OSM Fieltl 18. OSM Area 19. OSM 20. Type of Inspectior. 21. Joint Inspection 22. Inspector's ID <br />Ofllca No. Olflce No. SdmDle No. <br />m D (Cotle) Yes No <br />~TJ ~ No. <br />I°~ <br />~,,, [~ <br />23. Status 24. Type pr Activity (check appncgble cores). <br />A C] i Type of Permit <br />A r I Steep SIODe <br />l_J <br />E ^ Antltracde <br />B ~ Mine Status (Cadet B ~ Mounla in fop Removal d <br /> <br />C ~ TyDe of Facility (Cotle) F ~ Fe <br />eral Lands <br /> C ~ Prime Farmlands G ~ Intlian Lands <br />D J V^_ ~+ U• J Number of Permmed Ar.res <br />D ~ Alluvial Valley Floors <br />H Other <br />E J J ~ 5 • '.n Number of Disturbed Acres <br />26. Performance Stanoartl=_ (Codes! <br />In•iruetbnc Indicate compliance code. For any standard marked 2 or 3 provide narrat rve to support this tlererminati~n. <br />Slantlards Thal Limit the Effects to the Permit Area Stantlartls That Assu•e Reclamatior. Quality and Timeliness <br />A ~ Distance Prohibitions M ~ Topsoil Handling <br />B ~ Mlning WIMIO Permit Boundaries N ~ Back!iumq aria Gratlmg <br />C ~ Slpns and Markers O ~ Fcllowing Reclamation Sched~ile <br />D ~ Sediment Control Measures P ~ Revegetation Requirements <br />E ~ Design end Certification Requirements- O ~ Disposer of Excess Spoil <br />Sediment Control <br />R ^i Handling of Acid or Toxic Materials <br /> <br />F ~ Ellluent Limits <br />S ^ Mighwall Elimination <br />G ~ Surtace Water Monitoring <br />T ~ Oownslope Spoil Disposal <br />H ~ Grountl Water Monitoring J <br />I ~ Blasting Procetlures U ~ Post Mming Lantl Use <br /> i <br />C <br />O <br />T <br /> <br />J O Haul/Access Road Design and Maintenance V ~ <br />essat <br />on of <br />perations: <br />emporary <br /> <br />K ~ Refuse Impoundments W ~ Other <br />L ~ Ofher. SPecNy <br />Dlelrloullon: Original ~ Field Ollice, Green ~ Headquarters, Blue ~ Stele's Copy, Yellow ~ Inspector's CODY~ Pink ~ File Copy IE ~ 763 (1/83) <br />