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For The Foll~,ring 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 ana Violations (NOV) ur Cessation Order (CO) issues, B = Inspected and both Comments noted 8 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 ana location of sample taken under comment section. GENERAL INSPECTION TOPICS: CORDS........... L Y/ NA /~/ R / Y / B / T / S LCJ SIGNS AND MARKERS ................. L Y / NA / N / R / Y / B / T / S J LCJ ROADS ............................. Y / NA / N / R / V / B / T / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N / R / V / B / T / S j LCJ BACKFILL 8 GRADING ................ L Y / NA ~/ R / V / B / T / S lC] EXPLOSIVES ........................ l Y / NA / N/ R / V / B / T / S j LCJ PROCESSING WASTES ................. L Y / ® / N / R / V / B / T / S j LCJ SUPPORT FACILITIES ................ LQY / NA / N / R / V / B / T / S ] LCJ TOPSOIL ........................... L Y / NA /Q/ R / V / B / T / S .1 LCJ GENERAL MINE PLAN COMPLIANCF_,,,,,, L Y / NA / N / R / V / B / T / S J LCJ FISH 8 WILDLIFE ................... L Y / NA /~/ R / V / B / T / 5 J LC] REVEGETATION ...................... L Y / NA /~/ R / 4 / B / T / S ] LCJ AIR RESOURCE PROTECTION........... L Y / NA /~/ R / V / B / T / S LCJ SLIDES 8 DAMAGE ................... ~/ NA / N / R / V / B / T / S J LCJ SUBSIDENCE ........................ L Y / NA /~/ R / V / B / T / S J LCJ EXCESS SPOIL 8 DEVELOPMENT WASTE.. ~ NA / N / R / V / B / T / S J LCJ OFFSITE SUPPORT FACILIIIES......,. L Y /~ / N / R / V / B / T / S LCJ RECLAMATION SUCCESS ............... L Y / NA /QN / R / V / B / T / S ] LCJ SPECIAL CATEGORIES OF MINING...... ! Y /~ / N / R / Y / B / T / S J (1) L20 (2) -------------------- Spaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y /~/ N/ R/ V/ B/ T J (1) L20 (2) -------------------- Spaces (3) -------------------- MaxJ -------------------- NOTE: LCJ = Required Entry.