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For the Following Entries, Circle the Appropriate Choice: <br />Y = Inspected and Found in Compliance <br />N = Not Inspected <br />R = Inspected and Comments Noted <br />V = Inspected and Violations (NOV) or Cessation Order (CO) Issued <br />NA = Inspection Topic Not Applicable <br />GENERAL INSPECTION TOPICS: <br />[C] AVAILABILITY OF RECORDS ................ ...... Y / N / OR / V / NA <br />[C] SIGNS AND MARKERS ...................... ...... YO / N / R / V / NA <br />[C1 ROADS .................................. ...... Y / N / R / V / <br />[C] HYDROLOGIC BALANCE ..................... ...... Y / N / R / V / <br />[C] BACKFILL & GRADING ..................... ...... Y / N / R / V / <br />[C1 EXPLOSIVES ............................. ...... Y / N / R / V / <br />[C] PROCESSING WASTE ....................... ...... Y / N / R / V / ~tvty <br />X <br />[C] SUPPORT FACILITIES ..................... ...... Y / N / R / V / h. <br />vzJ <br />[C1 TOPSOIL ................................ ...... Y / N / R / V / <br />[C] GENERAL MINE PLAN COMPLIANCE ........... ...... Y / N / R / V / NA <br />[C] FISH & WILDLIFE ........................ ...... Y / N / R / V / NA <br />[C] REVEGETATION ........................... ...... Y / N / OR / V / NA <br />[C] AIR RESOURCE PROTECTION ................ ...... Y / N / R / V / <br />[C] SLIDES & DAMAGE ........................ ...... Y / N / ® / V / NA <br />[C] SUBSIDENCE ............................. ...... Y / N / R / V / N® <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE ....... ...... Y / N / R / V / <br />[C] OFFSITE SUPPORT FACILITIES ............. ...... Y / N / R / V / <br />[C] RECLAMATION SUCCESS .................... ...... YO / N / R / V / NA <br />[C] SPECIAL CATEGORIES OF MINING ........... ...... Y / N / R / V / <br />(1) - <br />(2) <br />(3) <br />[C1 OTHERS ....................................... Y / N / R / V / <br />(1) - <br />(2) - <br />(3) - <br />Page 2 <br />