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For The Foll~v,ing Entries, Circle The Appropriate Choice: = nspec a an oun in 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 Ur der 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 comment section. GENERAL INSPECTION TOPICS: CORDS........... L Y / NA / CN }~ R / V / B / T / S J lC] SIGNS AND MARKERS ................. L ®/ NA / N / R / V / B / T / S LCJ ROADS ............................. Lam/ NA / N / R / V / B / T / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N /®/ V / B / 7 / S J LCJ BACKFILL & GRADING ................ L Y /~ / N / R / V / 6 / T / S LCJ EXPLOSIVES ........................ l Y/ ®/ N/ R/ V/ B/ T/ S J LCJ PROCESSING WASTES ................. L Y / ® / N / R / Y / B / T / S J LCJ SUPPORT FACILITIES ................ L ~ / NA / N / R / Y / B / T / S LCJ TOPSOIL ........................... L Y / NA / ©/ R / V / B / T / S J LCJ GENERAL MINE PLAN COMPLIANCE...... L ~' NA / N / R / V / B / T / S LC1 FISH 8 WILDLIFE ................... L Q/ NA / N / R / V / B / T / S J LCJ REVEGETATION ...................... L Y / ~ / N / R / V / B / T / S LCJ AIR RESOURCE PROTECTION........... L QY / NA / N / R / V / B / T / S LCJ SLIDES & DAMAGE ................... L Y / ® / N / R / V / B / T / S J LCJ SUBSIDENCE ........................ L Y / NA / ®/ R / V / B / 7 / S J LCJ EXCESS SPOIL 8 DEVELOPMENT WASTE.. L QY / NA / N / R / V / B / T / S J LCJ OFFSITE SUPPORT FACILITIES........ L Y / ® / N / R / V / B / T / S LCJ RECLAMATION SUCCESS ............... L Y / ® / N / R / V / B / T / S LCJ SPECIAL CATEGORIES OF MINING...... L Y / N® / N / R / V / B / T / S J (1? L20 (2) -------------------- SDaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y/ NA / N /~ V/ B/ T J (2j ~C1d1Q..~--------------- LSDaces (3) -------------------- MaxJ - - - - - - - - - - - - - - - - - - - - NOTE: LCJ Required Entry.