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For the Following Entries, Circle the Appropriate Choice: Y = Inspected and Found in Compliance NA = Inspection Topic Not Applicable N = Not Inspected R = Inspected and Comments Noted V = Inspected and Violations (NOVI or Cessation Order (CO) Issued B =Inspected and Both Comments Noted and Violations or Cessation Orderlssued T =Ten-Day Notice Issued by OSM Oversight Personnel S =Sample Taken and Sent to the Lab for Analysis (Describe type and location of sample taken under Comment section.) GENERAL INSPECTION TOPICS: IC] AVAILABILITY OF RECORDS ............. ... Y / NA / ~ / R / V / B / T / S lCl SIGNS AND MARKERS ................. ... Y / NA / N / R / V / B / T / S [Cl ROADS ........................... ... Y ! NA / N / R / V / B / T / S [C] HYDROLOGIC BALANCE ............... ... Y / NA / N / R / V / B / T / S [C] BACKFILL & GRADING ................. ... Y / A / N / R / V / B / T / S [C] EXPLOSIVES ........................ ... Y ! A / N / R / V / B ! T S lC] PROCESSING WASTE ................. ... Y / / N / R / V / B / T / S [Cl SUPPORT FACILITIES ................. ... Y / NA / N / ~ / V / B / T / S [CI TOPSOIL .......................... ... Y / NA / N /®/ V / B / T / S [C] GENERAL MINE PLAN COMPLIANCE ....... ... ~ / NA / N / R / V / B / T / S [C) FISH & WILDLIFE ..................... ... Y / NA ~ / R / V / B / T / S [C] REVEGETATION ..................... ... Y / NA / N /~/ V / B / T / S [C] AIR RESOURCE PROTECTION ............ ... ~Y ! NA ! N / R / V / B / T / 5 [C] SLIDES & DAMAGE ................... ... Y / A / N / R / V / B / T / S [C] SUBSIDENCE ....................... ... Y / NA / N / R / V / B ! T / S [CI EXCESS SPOIL& DEVELOPMENT WASTE ... ... Y / A I N / R / V / B / T / S ICI OFFSITE SUPPORT FACILITIES ........... ... Y / N / N / R / V / B / T / S [C] RECLAMATION SUCCESS .............. ... Y / A N / R / V / B / T / S [Cl SPECIAL CATEGORIES OF MINING ........ ... Y / NA N / R / V / B / T I S (1) - - - - - - - - - - - - - - - - - - - - (2) - - - - - - - - - - - - - - - - - - - - (3) - - - - - - - - - - - - - - - - - - - - [CI OTHERS ........................... ... Y / NA N / R ! V / 8 / T (11 - - - - - - - - - - (2) - - - - - - - - - - - - - - - - - - - - (3) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -