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For The Following Entries, Circle The Appropriate Choice: Y = lnspeCLeU and round to COmpltanCe, 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 of sample taken under comment section. GENERAL INSPECTION TOPICS: CORDS........... L Y / NA / N / ®/ V / B / T / S LCJ SIGNS AND MARKERS ................. L~! / NA / N / R / V / B / T / S ] LCJ ROADS ............................. L ©/ NA / N / R / V / B / T / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N /® / V / B / T / S LCJ BACKFILL & GRADING ................ L Y / RC~ / N / R / V / B / T / S LCJ EXPLOSIVES ........................ L LYE/ NA / N / R / Y / B / T / S LCJ PROCESSING WASTES ................. L Y/ ®/ N / R / V / B / 7 / S l LCJ SUPPORT FACILITIES ................ L~/ NA / N / R / V / B / T / S ] LCJ TOPSOIL ........................... L~ / NA / N / R / V / B / T / S J LCJ GENERAL MINE PLAN COMPLIANCF_,.,,,, L ld / NA / N / R / Y / B / T / S J LCJ FISH & WILDLIFE ................... L~j / NA / N / R / V / B / T / S J LCJ REYEGETATION ...................... L Y/ ~I / N / R / V / B / T / S J LCJ AIR RESOURCE PROTECTION........... L~j/ NA / N / R / V / B / T / S J LCJ SLIDES & DAMAGE ................... L Y / ~ / N / R / V / B / T / S J LCJ SUBSIDENCE ........................ L d / NA / N / R / V / B / T / S LCJ EXCESS SPOIL & DEVELOPMENT WASTE.. L(>~j / NA / N / R / V / B / T / S LCJ OFFSITE SUPPORT FACILITIES........ L Y / J~A / N / R / V / B / T / S J LCJ RECLAMATION SUCCESS ............... L Y /~ / N / R / V / B / T / S LCJ SPECIAL CATEGORIES OF MINING...... L Y / ~ / N / R / V / B / T / S (1) L20 (2) -----------'-------- SDaces (3) -------------------- MaxJ - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y/~/ N/ R/ V/ B/ T J (2) -------------------- LSPaces (3) -------------------- MaxJ - - - - - - - - - - - - - - - - - - - - NOTE: LCJ = Required Entry.