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' ~ Unlt(~tates Department of the Interior. Office of Surface Mining Mine Site Evaluation Inspection Report ?H Slate P«mn Number 27. Date of Inspection (YYMMDD) ffi Yes No DO mining and reclamation activities on the site comply with the plans in the permit? ^ ^ If no, rovide namatlve to su ort this determination . - ;,~ ;..~- ,-._ . ~- ~~ ?B. Indkate number of complete end pertlal inspections conducted by the State to date for this annual review period: - ~ ~ ~~- - ~.. a 29a ~ ~, Number o1 ComDletes 29b. ~ Number of Partials 30. Indicate number of complete and pertlal Inspections required by the State during this annual review period: ~. 'r 31k ~ Number of Completes 30b. ~ Number of Partials ~1 ; `~ _ .~ ~ -, 3f. Hn Irnperilon frequency been met? Ysa No Yes No 31a ^ ^ Completes 31 b. - ^ ^ Partials 32 FEDf7iAL ENFORCEMENT INFORMATION. (Enter violation number. Check appropriate bon(es)] Tar-Dry Nonce No, Notice of Violation No. Cessation Order No. Violation Codes A ^ Authorizations to O orate P B^ ....... .................. . .............. ........................ SI ns and Markers a . .................... ^ ....... C ^ .............. ^ ........................ Backfllling and Gredinp . D ^ ..................... ^ ...... ............... ^ ........................ Highwall Elimination ^ E ^ ^ ........................ Rills and Gullies ....... ..................... .. .... .... ....... ^ ....... F ^ .............. .............. ^ ........................ Improper Fllla .. . . ................ ^ ...... .. r' ^ ............... ^ ........................ Topsoil Handling .. . H ^ ..................... ^ ^ Sediment Ponds ^ f ^ .. ... ^ ........................ Effluent Llmlts ............. _....... ....... ~ ^ ..................... ^ ...... ....... . . ............... ^ ........................ Water Monitoring K ^ ..................... ^ ...... ............... ........................ Buller Zones ~ ^ ..................... ^ ...... ............... ^ ........................ Roads ^ ~ ^ . ^ ........................ Dams ...... ..................... N ^ ..................... ^ ...... ............. . ............... ^ ........................ 8lastlng O ^ ...... ............... ........................ Rave station ~ P ^ ..... ................ ^ ...... ............... ^ ........................ Spoil on the DownsloPe O ^ ..................... ^ ...... ............... ^ -....................... Mlning Without Permit R ^ ..................... ^ ...... ............... ^ ........................ EnceedlnQ Permit Llmlts S ^ ..................... ^ ...... ............... ^ ........................ Dlatance Prohibitions T ^ ..................... ^ ...... ............... Tonic Materials ~ ^ ^ ^ Other Vlolationa 33 Name of AWhorimd Representative (print or type) ~i.~ 4 Slgrratme of AuUwrlad Representative Date ~ 0 v O CT n < < ( ~ U ~ '5 ~Slpnafwe af; RevieWnygOfflciaYl•, Dafe 0 3 S -r F 1 ,, Obaawtlorc OrIQIrW -Field ONke, Green ~ Meetlquartere, B1ua ~ Sttla'a Copy, YNlow - Inepector•e Copy. Pink ~ File Copy IE ~ 1&7 (1la7)