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.t'-~ <br />Papa i of 2 Pages <br /> Unite tales Department of the Interior <br /> Office of Surtace Mining <br /> Mine Site Evaluation Inspection Report <br />28. State Permit Number 27. Date of Inspection. <br /> YMMDD <br /> <br />28. Yes No Do mining end reclamation actlvltlea on the site comply with the plane In the permlt7 <br />^ If no rovide narrative to su ort this determination. <br />2g. Indicate number of complete antl partial Inepectlons conducted by the State to date for this annual review period: <br />298. ~ Number of Completes 29b. ~ Number of Pertlals <br />30. Indicate number of complete end Dertlal Inepectlons required by the State during This annual review period: <br />308. ~ Number of Completes 30b. ~ Number of Pertlals <br />31. Has Inapecllon frequency been mall <br />Yea No Yes No <br />31 a. ^ `~ Completes 31 b. ^ ~ Pertlals <br />32. FEDERAL ENFORCEMENT INFORMATION. (Enter violation number. Check appropriate box]esl] <br />Ten-Day Notice No. Notice of Vloletlon No. Cessation Order No. Vloletlon Codes <br />A ^ ^ ^ Authorizations to Operate <br />e ^ ^ ^ Signs end Merkera <br />C ^ ^ ^ Backfllling and Gratling <br />D ^ ^ ^ Hlghwall Elimination <br />E ^ <br />.. ^ ....... .............. ^ ........................ Rills and Gulllea <br />.................. <br />. <br />F ^ ^ ^ Improper Fills <br />G ^ ................. .... ^ ^ Topsoil Handling <br />H ^ ..................... ^ ^ Sediment Ponds <br />I^ ..................... ^ ^ EffluentLlmits <br />J ^ ..................... ^ ^ Water Monitoring <br />K ^ ^ ^ ........................ Buffer Zones <br />L ^ ..................... ^ ....... .............. ^ ........................ Roatla <br />M ^ ..................... ^ ....... .............. ^ ........................ Dams <br />N ^ ..................... ^ ....... .............. ^ ........................ Blasting <br />O ^ ^ ^ ........................ Revegatatlon <br />p ^ ^ ^ Spoil on the Downalope <br />O^ ^ ^ Mining Without Permit <br />R ^ ^ ^ ~ Exceeding Permit Llmlts <br />S ^ ^ ^ Distance Prohibitions <br />T ^ ^ ^ Toxic Materials <br />~ ^ ..................... <br />....... <br />^ ^ ........................ <br />.............. Other Violations <br />33. Name of Authorized Representative (print or type) <br /> <br />Signature of Authorized Representative Date -~ <br />'-_ <br />) <br />/ Q-. <br />t .. <br />- <br />Signature of ReW <br />ew^ing Offlc~al ~ ,_~ Date / ~~ . _ ~ ,1 <br />~ b ~ <br /> ~~ <br /> ,. <br />Distribution: Original -Field Otfice, Green - Headquarters, Blue -State's Copy, Yellow - Inspeotar'a Copy, Plnk - Flle Copy IE - 163 (1/831 <br />