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i~ ~. ..r ?~"t. ~.tP. ~. i n,nc rf <br />• <br />• <br />For The Following Entries, Circle The Approrpiate Choice: <br />r = inspecLea ana rouna in compliance, <br />NA = Inspection Topic not applicable, <br />N =Not Inspected, <br />R =Inspected and Comments noted, <br />V =Inspected and Violations (NOV) or Cessation Order (CO) issued, <br />B =Inspected and both Comments noted & Violations or Cessation <br />Order issued, <br />T = 10 Day Notice Issued by OSM Oversight Personnel, <br />S =Sample taken and sent to the lab from analysis -describe <br />type and location of sample taken under comment section. <br />GENERAL INSPECTION TOPICS: <br />C AVAILABILITY OF RECORDS........... [ Y / NA /~ / R / V / B / T / S ] <br />[C] SIGNS AND MARKERS ................. [~ / NA / N / R / V / B / T / S ] <br />[C] ROADS ............................. [ YO/ NA / N / R / V / B / T / S ] <br />[C] -HYDROLOGIC BALANCE ................ [ Y / NA / N /®/ V / B / T / S ] <br />[C] BACKFILL & GRADING ................ [ Y /~ / N / R / V / B / T / S ] <br />[C] EXPLOSIVES ........................ [ Y / NA /~/ R / V / B / T / S ] <br />[C] PROCESSING WASTES ................. [ Y / NA / N / R / V / B / T / S ] <br />[C] SUPPORT FACILITIES ................ [ / NA / N / R / V / B / T / S ] <br />[C] TOPSOIL ........................... [ Y / NA /~/ R / V / B / T / S ] <br />[C] GENERAL MINE PLAN COMPLIANCE...... [ Y / NA / N /~/ V / B / T / S ] <br />[C] FISH & WILDLIFE ................... [~/ NA / N / R / V / B / T / S ] <br />[C] REVEGETATION ...................... [ Y / NA / NQ/ R / V / B / T / S ] <br />[C] AIR RESOURCE PROTECTION........... [~ / NA / N / R / V / B / T / S ] <br />[C] SLIDES & DAMAGE ................... [ Y / f~/ N / R / V / B / T / S ] <br />[C] SUBSIDENCE ........................ [ Y / NA /ON / R / V / B / T / S ] <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE.. [ Y / NA /~/ R / V / B / T / S ] <br />[C] OFFSITE SUPPORT FACILITIES........ [ Y / NA / N / R / V / B / T / S ] <br />[C] RECLAMATION SUCCESS ............... [ Y / NA /~/ R / V / B / T / S ] <br />[C] SPECIAL CATEGORIES OF MINING...... [ Y / NA / N / R / V / B / T / S ] <br />(1) [20 <br />- - - - - - - - - - - - - - - - - - - - <br />(2) Spaces <br />(3) -------------------- Max] <br />- - - - - - - - - - - - - - - - - - - - <br />[C] OTHERS ............................ [ Y / NA / N / R / V / B / T ] <br />(1) <br />(3) - - - - - - - - - - - - - - - - - - - - <br />- - - - - - - - - - - - - - - - - - - - <br />NOTE: [C] = Required Entry. <br />r.. .., ..iM1in~r;aYCfu .n.R,e ar..i-S.' wrv-~ .n-+...Y.%dA"4f+"er'1... ..~:'~:~~.~F~.~Cie'~~ iz a "N <br />[20 <br />Spaces <br />Max] <br /> <br />