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For The NA N R Y B T S Follawing Entries, Circle The Appropriate Choice: nsp?c a an oun in comp lance, Inspection Topic not applicable, Nit Inspected, Inspected and Comments noted, Inspected and Violations (NOV) dr Cessation Order (CO) issues, Inspected and both Comments noted 8 Violations or Cessation Ur der issued, 10 Day Notice Issueo by OSM Oversight Personnel, 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 / N/ V/ B/ T/ S LCJ SIGNS AND MARKERS ................. L Y / NA / N / R / V / B / T / S J LCJ ROADS ............................. L Y / NA / N / R / V / B / T / S LCJ HYDROLOGIC BALANCE ................ L Y / NA / N / R V / B / T / S LCJ BACKFILL 8 GRADING ................ L Y/ NA / N/ V/ B/ T/ S J LCJ EXPLOSIVES ........................ L Y/ A/ N/ R/ V/ B/ T/ S j LCJ PROCESSING WASTES ................. L Y/ A/ N/ R/ V/ B/ T/ S J LCJ SUPPORT FACILITIES ................ L Y / A / N / R / Y / 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 / 8 / T / S LCJ FISH & WILDLIFE ................... L Y / NA / N / R / V / B / T / S ] LCJ REVEGETATION ...................... L Y / NA / N / R / V / B / T / S LCJ AIR RESOURCE PROTECTION........... L Y / ~/~N / R / V / B / T / S ] LCJ SLIDES 8 DAMAGE ................... L Y/ N / N/ R/ V/ B/ T/ S J LCJ SUBSIDENCE ........................ L~/ NA / N / R / V / B / T / S J LCJ EXCESS SPOIL 8 DEVELOPMENT WASTE.. L Y / ~/ N / R / V / B / T / S ] LCJ OFFSITE SUPPORT FACILITIES........ L Y/ A/ N / R / V / B / T / S l LCJ RECLAMATION SUCCESS ............... L~/ / N / R / V / B / T / S LCJ SPECIAL CATEGORIES OF MINING...... L Y / ~ NA / N / R / V / B / T / S J (1) L20 (2) -------------------- Spaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y/ NA / N/ R/ V/ B/ T J (1) L20 (2) - - - - - - - - - - - - - - - - - - - Spaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - NOTE: lCj Required Entry.