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~'r <br />For The Followin Entries, Circle The Approrpiate Choice: <br />= nspecte an out-in compT•iance, <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 b 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 ............................. [~/ NA / N / R / V / B / T / S ] <br />[C] HYDROLOGIC BALANCE ................ ~/ NA / N / R / V / B / T / S ] <br />[C] BACKFILL & GRADING ................ [O/ NA / N / R / V / B / T / S ] <br />[C] EXPLOSIVES ........................ [ Y / NA / N / R / V / B / T / S ] <br />[C] PROCESSING WASTES ................. [ Y / NA / N / R / V / B / T / S ] <br />[C] SUPPORT FACILITIES ................ [O/ NA / N / R / V / B / T / S ] <br />[C] TOPSOIL ........................... [~Y / NA / N / R / V / B / T / S ] <br />[C] GENERAL MINE PLAN COMPLIANCE...... [~' NA / N / R / V / B / T / S ] <br />[C] FISH & WILDLIFE ................... [ Y / NA /©/ R / V / B / T / S ] <br />[C] REVEGETATION ...................... [~/ NA / N / R / V / B / T / S ] <br />[CJ AIR RESOURCE PROTECTION........... [ Y / NA /~/ R / V / B / T / S ] <br />[C] SLIDES & DAMAGE ................... [©/ NA / N / R / V / B / T / S ] <br />[C] SUBSIDENCE ........................ [ Y /~ N / R / V / B / T / S ] <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE.. [ Y /~/ N / R / V / B / T / S ] <br />[C] OFFSITE SUPPORT FACILITIES........ [ Y / NA / N / R / V / B / T / S ] <br />[C] RECLAMATION SUCCESS ............... [QY / NA / N / R / V / B / T / S ] <br />[C] SPECIAL CATEGORIES OF MINING...... [ Y /~ / N / R / V / B / T / S ] <br />(1) [20 <br />- - - - - - - - - - - - - - - - - - - - <br />(2) Spaces <br />(3) -------------------- Max] <br />- - - - - - - - - - - - - - - - - - - - <br />[C] OTHERS ............................ [ Y / ®/ N / R / V / B / T ] <br />(1) [20 <br />( ) -------------------- Spaces <br />2 <br />(3) -------------------- Max] <br />NOTE: [C] = Required Entry. <br />