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For The Following Entries, Circle The Appropriate Choice: = nspec a an oun to comp Lance, NA = Inspection Topic not applicable, N =Not Inspected, R =Inspected and Comm ents n oted, V =Inspected and Viol atio ns (NOV) dr Cessa ti on Order ( CO) issued, B =Inspected and both Com me nts noted & V io la tion s or C essation Order issued, T = 10 Day Notice Issu ed by OSM Oversight Per sonn el , S =Sample taken and s ent to the lab from analysi s - describe type and location of s ample taken under comme nt section, GENERAL INSPECTION TOPICS: CORDS........... L Y / NA /~/ R/ V / B / T / S LCJ SIGNS AND MARKERS ................. L Y / NA / N /~ V / 8 / T / S J LCJ ROADS ............................. l~/ NA / N / R / V / B / T / S LCJ HYDROLOGIC BALANCE,,,,,,,,,,,,,,,, L Y / NA / N ~ V / B / T / S J LCJ BACKFILL & GRADING ................ L Y / NA / N /~ Y / B / T / S J lC] EXPLOSIVES ........................ L Y / NA ~ R/ V / B / T / S J LCJ PROCESSING WASTES ................. L Y / NA / N R/ V / B / T / S J LCJ SUPPORT FACILITIES ................ L Y / NA / N R / V / B / T / S lCJ TOPSOIL ........................... L Y / NA /~ R / V / B / T / S LCJ GENERAL MINE PLAN COMPLIANCE,.,,,, ~/ NA / N / R / V / B / T / S J LCJ FISH & WILDLIFE ................... L Y / NA /©' R / V / B / T / S LCJ REVEGETATION ...................... L Y / NA /~ R / V / B / T / S ] LCJ AIR RESOURCE PROTECTION........... L Y / NA /~ R / V / B / T / S LCJ SLIDES & DAMAGE ................... L Y NA / N / R / V / B / T / 5 ] LCJ SUBSIDENCE ........................ L Y / NA ~ R / V / B / T / S LCJ EXCESS SPOIL & DEVELOPMENT WASTE.. L Y / NA / N ~/ V / B / T / S LCJ OFFSITE SUPPORT FACILITIES........ L Y NA N/ R/ V / B / T / S J LCJ RECLAMATION SUCCESS ............... L Y / NA /~ R / Y / ft / T / S J lCJ SPECIAL CATEGORIES OF MINING...... L Y NA / N / R / V / B / T / S (1) L20 (2) -------------------- Spaces (3) -------------------- MaxJ - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y~/ N/ R/ V/ B/ T (1) L20 (2) -------------------- Spaces (3) -------------------- MaxJ - - - - - - - - - - - - - - - - - - - - NOTE: LCj = Required Entry.