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For The Follo~~ing Entries, Circle The Appropriate Choice: = nsp?C a an dun to comp lance, NA = Inspection Topic not applicable, N Nit Inspected, R =Inspected and Comments noted, Y Inspected and Violations (NOV) or 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 and location of sample taken under comment section. GENERAL INSPECTION TOPICS: CORDS........... L Y / ®/ N / R / V / B / T / S ] LC1 SIGNS AND MARKERS ................. L Y / NA / N /®/ V / B / T / S J LCJ ROADS ............................. L Y / NA / N / ®/ V / B / T / S J LCJ HYDROLOGIC BALANCE ................ L Y / ®/ N / R / V / B / T / S j LCJ BACK FILL 8 GRADING ................ L Y / ~/ N / R / V / B / T / S ] LCJ EXPLOSIVES ........................ L Y / ~/ N / R / V / B / T / S J LCJ PROCESSING WASTES ................. L Y / ~/ N / R / V / B / T / S ] LCJ SUPPORT FACILITIES ................ L Y /~/ N / R / V / B / T / S ] LCJ TOPSOIL ........................... L Y / ®/ N / R / V / B / T / 5 J lC] GENERAL MINE PLAN COMPLIANCE...... L Y / ®/ N / R / Y / B / T / S 1 LCJ FISH 8 WILDLIFE ................... L Y / 1~ / N / R / V / B / 7 / S J LCJ REVEGETATION ...................... L Y / ~/ N / R / V / B / T / S ] LCJ AIR RESOURCE PROTECTION........... L Y / ® / N / R / V / B / 7 / S J LCJ SLIDES & DAMAGE ................... L Y /~ / N / R / V / B / T / S ] LCJ SUBSIDENCE ........................ L Y / ®/ N / R / V / B / T / S J LCJ EXCESS SPOIL 8 DEVELOPMENT WASTE.. L Y / ~A / N / R / V / B / T / S ] LCJ OFFSITE SUPPORT FACILITIES........ L Y /~/ N / R / Y / B / 7 / S J LCJ RECLAMATION SUCCESS ............... L Y / IQ / N / R / V / B / T / S ] LCJ SPECIAL CATEGORIES OF MINING...... L Y / ~ N / R / V / B / T / S J (1 ) L20 (2) -------------------- SDaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y / NA / N /t~ V / B / T ] (2) ~4~~-Le~~QL2Z--------= LSPaces (3) -------------------- MaxJ - - - - - - - - - - - - - - - - - - - - NOTE: LCJ = Required Entry.