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For The Foll~r~irtg Entries, Circle The Appropriate Choice: = nspec a an oun to Comp Lance, NA = Inspection Topic not applicable, N = Nit Inspected, R =Inspected and Comments noted, V = Inspected and Violations (NOV) or Cessation Order (CO) issued, 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 / NA /~ R / V / B / T / S ] LCJ SIGNS AND MARKERS ................. L Y / NA / N ~/ V / B / T / S ] LCJ ROADS ............................. ~/ NA / N / R / V / B / T / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N ®/ V / B / T / S J LCJ BACKFILL 8 GRADING ................ L Y / NA / N ~/ V / B / T / S ] LCJ EXPLOSIVES ........................ L Y / NA ~ R / Y / B / T / S j LCJ PROCESSING WASTES ................. L Y / NA ~/ R / V / B / T / S J LCJ SUPPORT FACILITIES ................ L Y / NA /®/ R / V / B / T / S ] LCJ TOPSOIL ........................... L Y / NA /~ R / V / B / T / S J LCJ GENERAL MINE PLAN COMPLIANCE...... ~ NA / N / R / V / B / T / S J LCJ FISH 8 WILDLIFE ................... L Y / NA / N ~/ V / B / T / S ] LCJ REVEGE7ATION ...................... L Y / NA ,®/ R / V / B / T / 5 ] LCJ AIR RESOURCE PROTECTION........... L Y / NA ~/ R / V / B / T / S J LCJ SLIDES 8 DAMAGE ................... L Y / NA / R / V / B / T / S ] LCJ SUBSIDENCE ........................ L Y ~ / N/ R / V / B / T / S ] LCJ EXCESS SPOIL 8 DEVELOPMENT WASTE.. L Y / NA /Ct~1' R / V / B / T / S ] LCJ OFFSITE SUPPORT FACILITIES........ L Y ~/ N / R / V / B / T / S ] LCJ RECLAMATION SUCCESS ............... L Y / NA ,/ ~ i rte/ R / Y / B / T / S ] LCJ SPECIAL CATEGORIES OF MINING...... L Y /~/ N / R / V / B / T / S J (1) L20 (2) ------------- ------- SDaces (3) ------------- - - - - - - - - - - - - - ------- - - - - - - - Max] LCJ OTHE N /~/ V / B / T ] ............... L Y~ / RS............ J ~~J~ Qr~ 1L f2~ ~1~~ ~f G~S LE Yi1~ L (2) . . .., _ L ~ Spaces (3) - - - - - - - - - - - - - - - - - - - - Maxj NOTE: LCJ Required Entry.