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<br />'z= ; ~ ~~~~Ii/E®. 1111111111111.1111u <br />w~7,`sx q k~ar. '<' ` ; c:' t• 999 • u a . . <br />E X °trM <br />~.1 ~ United States Department of the Interior MINED ND For Ofhce Use Only ~, <br />~.s ;. ~.~~s,-~,~+Offtce of Surface Mlning WF,~~ECLAMATIO DIV,SION ,~~~~1b, p, <br />~'G' ~ Mme Srte Evaluation Inspectwn Report -~ ~~ <br />y+ ~ ~~~ r ! , yid ~ A¢' y~ ~"'fS'~~,.f`+°~~SFr''~s+''~"' ~ ~ ~ s >r °r- •~ <br />• ~ma tik i :~ ho- .3C.~r ', ar.~ r Y J <br />.V>~~~x t .~f~"~a";, t ~~f,e ~~'. , :, ~ X~,.,,"``wvt* `~ x w. _ A !~. ~Y r M M ;' Baten a .t~-Q~"-~pepor•. Ge^ <br />.n , <br />y <br />b:^ ~ ~t • ' .~ -_. ~. . ; . - 10. Date o! Inspection u <br />2:~Name of Permittee ~ - ~' .4z ^`~' ~' ~ 9. MSHA Number ~ ~ ~ ~~ • ~ (Y Y M M D D) ." <br />Rq~~Y` ~b'cS o -o , q- oat a <br />3. Street Atltlress ~ - ~ X11. Slate Permit Number <br />r <br />Po ~ D x G.o9. ~'°~` c= Boa- 1 r• <br />4. Clty ~ - .• "' - J.::'sn FH3W~....5!'°~t3:.'.a3. 5: State ".:.....: `_. ~12. Name of Mine . ' : ,. • ` ,: ?a~ ".:' . .. <br /> <br /> <br />`' 4 G !K ~ Y •' - <br />/~ - e T fie.: e r ;. : <br />l ... .v nl r ~ <br />~~ .c ~ o ~ . Ci h y c I <br /> <br />G~ <br />~ f. C KI ~ <br /> <br />d Y <br />•.. :. SL <br />~ .. w <br />p <br /> .. <br /> <br />8. Zlp Code . <br />.. q • v . <br />T Area Code y~ 8. Telephone Number . <br />. <br />c 13. County Code 14: State Code ~ ~ r <br />~- <br />15. Strata -16. State Area Othce <br />.' <br />' <br />.~ <br /> i: <br /> 17. OSM Flettl <br />Ofllce No. 18. OSM Area •~ 19. OSM' ~ _; Rf,"~r~•; .~, <br />Ofllce No. ~ Sample No _ - 20. Type of Inspection' ~ 27. Joint Inspectlon <br />. ICotlep +f+~ ~ Yes No ~u22. Inspector's 1D ..7=-.' <br />~ No. ; ~ '; ~. <br /> <br />23. Status <br />~, A G I ~ ~ TYDe of Permit <br />B ® ~ ~ Mlna Status (Coda) <br />C ®p ~ ~ Type of Facility (Code) <br />'~ D G. ~ a 0 p • O Number of Permitted Acres <br />- E .~ 0 U 3 • Number of Disturbed Acres <br /> 24. Type of Activity (check applicable boxes). ' <br /> A ~ Steep SIOPe ~ ~E ~ Anthracite <br /> B ~ Mountain Top Removal F ~ Federal Lands <br /> C ~ Prime Farmlands G ~ Indlan Lands <br /> D ~ Alluvial Valley Floors <br />- H ~ Other <br />~','' <br /> 25. Performance Slantlartls ICodesl <br />In•muellon•: Intllcatr compliance cotle. For any standartl marketl 2 or 3 Orovide narrative to support this tleterminatlon. <br />Standards That Llmll the Effects to the Permlt Area Slantlartls That Assure Reclamation Quality antl Timeliness <br />A ~ Distance Prohibitions ~ ~. ~ M © ToDSOiI Handling <br />B ~ Mlning Wlthln Permlt Boundaries N ~ Back!illing anb Grading u <br />C ~ Signs end Markers O ~ Following Reclamation Sctietlule <br />D ~ Sediment Control Measures P ~ Revegetahon Repuirements <br />E ~ Deslgn end Certiflcetlon Requirements- O ~ Disposal of Evicess Spoil <br /> Sediment Control <br />R <br />© Hantllrng of Acld or Toxic Materials <br />F ~ Effluent Llmlls <br />S <br />~ Hlghwall Elimination <br />G ~ Surface Water Monltorlnp <br />T <br />~ Downslope Spoil Disposal <br />H ~ Ground Water Monitoring <br />U <br />~ Post Mining Land Use <br />I ~ Blestln9 Procedures <br /> V ~ Cessallon of Operations: Temporary <br />J ~ HaullACCess Road Deslgn ono Maintenance <br /> W ~ Other <br />K ~ Refuse Impoundments <br />L ~ Other: Specily <br />,fit <br />'Y <br />~`~ <br />.. <br />DlstriDUllon: Original ~ Fieltl Office, Green -Headquarters, Blue ~ State's Copy. Yellow ~ Inspectoi s Copy. Pink -File CoDY IE ~ 16311183) <br />' .~'~wiT. ~{' rH"~-5+~+'.. ... .. .. - .. ~ ?s~#:„4 pfd <br />