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For the Foll~~,ing Entries, Circle The Appropriate Choice: = nspeC a an oun in co,np lance, NA = Inspection Topic not applicable, N = Nit Inspected, R =Inspected and Comments noted, Y = Inspected and Violations (NOY) ur Cessation Order (CO) issues, B = Inspected and both Comments noted & Violations or Cessation Order issued, T 10 Day Notice Issues by OSM Oversight Personnel, S =Sample taken and sent to the lab from analysis - tlescribe type and location of sample taken under comment section. GENERAL INSPECTION TOPICS: CORDS........... L Y / ~/ N / R / V / B / T / S ] LCJ 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 / NA / N / ®/ V / 8 / T / S J LCJ BACKFILL 8 GRADING ................ L Y / NA / N /®/ V / B / T / S J LCJ EXPLOSIVES ........................ L Y / ®/ N / R / V / B / T / S J Lr,J PROCESSING WASTES ................. L Y / ®/ N / R / V / B / T / S J LCJ SUPPORT FACILITIES ................ L Y / ~/ N / R / V / B / T / S J LC] TOPSOIL ........................... L YC~/ NA / N / R / V / B / T / S J LCJ GENERAL MINE PLAN COMPLIANCE...... L ®/ NA / N / R / Y / B / T / S J LCJ FISH & WILDLIFE ................... L ©/ NA / N / R / V / B / T / S J LCJ REVEGETATION ...................... L ®/ NA / N / R / V / B / T / S ] LCJ AIR RESOURCE PROTECTION........... L ~/ NA / N / R / V / B / T / 5 J LCJ SLIDES 8 DAMAGE ................... L Y / NA / N /(~/ V / B / T / S J LCJ SUBSIDENCE ........................ L Y / NC1~ / N / R / V / B / T / S J LCJ EXCESS SPOIL & DEVELOPMENT WASTE.. L Y / ~/ N / R / V / B / T / S J LCJ OFFSITE SUPPORT FACILITIES........ L Y / ~/ N / R / V / B / T / S ] LCJ RECLAMATION SUCCESS ............... L ©/ NA / N / R / V / B / T / S ] LCJ SPECIAL CATEGORIES OF MINING...... L Y / I~/ N / R / Y / B / T / S J (1) ------------------ l20 (2) SDaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y / NA / N /G37 / V / B / T ] - - - - - _ SDaces (3) ---------- --- Max] - - - - - - - - - - - - - - - - - NOTE: LCj Required Entry.