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~~~~~ ~ RECEIVED ~ ~~~ ~~~~~~~~~~~~~~~~ <br />„ ..,,, . <br />P•e• t a x woes <br /> <br />United States Department diI111~6gtgeqEDLAMATIDN DIVISI For Office Use Only <br />Office of Surface MlnpdQ Dept of Natural Resources <br /> <br />Mine Site Evaluation Inspection Report ,a <br />~ ,b ,p <br />m m <br /> ' Y Y M M Balch Report <br /> 10. Dots of Inspection <br />2. Noma of Parmlttae 9. MSHA Number ry Y M M D D) <br /> <br />3. Street AUdreee 11. State Permit Number <br /> ~' %- <br />4. City 5. Stets 12. Name of Mlne <br /> <br /> <br />8. Zlp Code 7. Area Code 8. Telephone Number 13. County Cotle 14. State Code 15. Strata 16. Slate Area Office <br /> <br />f7. OSM Field 18. OSM Area 19. OSM 7,0. Type of Inspection 21. Joint Inspection 22. Inspector's ID <br />Olllce No. Office No. Sample No. <br />~ ICotle) ~ Yes No <br />~ <br />~ ~ No. <br />/ <br /> ~ / - <br />23. Statue 24. Type of Activity (check applicable boxes). <br />q ~ Type of Permit rte-,( <br />A 1rr~ I Steep Slope <br />~ <br />E ~ Anthracite <br />B m Mlne Statue (Cooe} f <br />B ~ Mountain Top Removal F ® Federal Cantle <br />C ~ Type of Facility (Code) <br />C ~ Prime Farmlentls <br />G ~ Indian Lando <br />D -; (, a j. ;~ • ~- Number of Permitted Acree <br />D ~ Alluvial Valley Floors <br />H ~ Other <br />E j.v r ~ • (' Number of Dlaturbed Acres <br />25. PeAOrmance Standards (Cotles) <br />In•VUalonc Indicate compliance code. For any standard marked 2 or 3 provltle narrative to suppon this determinetlon. <br />Standards That Llmlt the Effects to the Permit Area Standards That Assure Reclamation Quality and 7lmellness <br />A ~ Dlatance Prohlbltlone M ~ Topsoil Handling <br />B © Mlnlnq Within Permit Bountlerlea N ~ Backllllinp and Gratlinp <br />C ~ Sipna antl Merkera O Q Following Reclamation Schedule <br />D ©Sedlmsnt Control Meaaurea P ~ Reve9etetion Requirements <br />E a Dealpn antl CeRiticatlon Requirements- O © Disposal of Excess Spoil <br />Sediment Canirol <br />R ~ Handling of Acitl or Toxic Materials <br />F Q! Effluent Llmlte S J~ Hlphwall Ellminatlan <br />G ~ Surface Water Monitoring <br />T ~ Downslope Spoil Dlaposel <br />H ~ Ground Water Monitoring <br /> <br />I ~ Blaslinp Procsduree U © Poet Mlnlnp Land Use <br /> V ~ Cessation o1 ODaratlons: Temporary <br />J ~ HaullACCeaa Road Deslpn and Maintenance <br />W ^ Other <br />K ~ Refuaa Impoundmante <br />L ~ Other. SpeeNy <br />Dlalrlbutlon: Original - F1eld Olflcs, Green - Heatlquartere, Blue -State's Copy, Yellow -Inspector's Copy, Plnk - Flle Copy IE ~ 1B3 (1183) <br />