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For The Foll~.,ing Entries, Circle The Appropriate Choice: = nspec a an oun in Comp lance, - NA Inspection Topic not applicable, N = Not Inspected, R =Inspected and Comments noted, V =Inspected ana Violations (NOV) or Cessation Order (CO) issues, B = Inspected and both Comments noted & Violations or Cessation Ur der issued, T 10 Day Notice Issued by OSM Oversight Personnel, S =Sample taken and sent to the lab from analysis - describe type ana location of sample taken under comment: section. GENERAL INSPECTION TOPICS: CORDS........... L Y / NA / NO / R / V / B / T / S LCJ SIGNS AND MARKERS ................. L Y / NA / N / ~/ V / B / 1' / S J LCJ ROADS ............................. L Y / NA / N / ®/ V / B / 1' / S 1 LCJ HYDROLOGIC BALANCE ................ L Y / NA / N / ®/ V / B / 1' / S LCJ BACKFILL 8 GRADING ................ L Y / It~ / N / R/ V / B / T / S J LCJ EXPLOSIVES ........................ L Y / NA / ®/ R / V / B / 1' / S J Lr;j PROCESSING WASTES ................. L Y / NA / N / ®/ Y / B / T / S LCJ SUPPORT FACILITIES ................ L Y / NA / N / ®/ V / B / '( / S ] LC7 TOPSOIL ........................... L Y / NA / N / ~/ Y / B / 'f / S J LCJ GENERAL MINE PLAN COMPLIANCE...... L®/ NA / N / R / V / B / '( / S ] LCJ FISH 8 WILDLIFE ................... L ~/ NA / N / R / V / B / 'i / S LCJ REVEGETATION ...................... L Y / NA / N / ®/ V / B / 'I / S ] LC1 AIR RESOURCE PROTECTION........... Lam/ NA / N / R / V / B / 'i / S LCJ SLIDES & DAMAGE ................... L Y / t~A / N / R / V / 8 / 'i / S ] LCJ SUBSIDENCE ........................ L Y / NA / ©/ R / V / B / i / S ] LCJ EXCESS SPOIL & DEVELOPMENT WASTE.. 1 4 / NA / N / R / V / B / 'i / S J LCJ OFFSITE SUPPORT FACILITIES........ L Y / NA / ~/ R / V / B / T / S ] 1CJ RECLAMATION SUCCESS ............... L Y / NA / N / ®/ V / B / T / S ] LCJ SPECIAL CATEGORIES OF MINING...... L Y / ©A / N / R / V / B / i / S J (1) 120 (2) -------------------- Spaces (3) `------------------- Max] - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y/ NA / N/®/ V/ B/ T 7 (2j -e O ~v D -~~~ 6 LZZ---------- LSDaces - - - - - - - - - - - - - ---'---- Max] (3) --------------------- NOTE: LCJ =Required Entry.