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:~ ~ ~ iii iiiiuiiiiiu iii <br />' ape t of Z Papes <br />!~ - <br />United States Department of the Interior For Office use Only <br />Office of Surface Mining <br /> <br />Mine Site Evaluation Inspection <br />Report ,a <br />~ ,b ,p <br />~ m <br /> Y Y M M Balch BeDOr1 <br />2. Name of Permitlee 9 MSHA Number [0 D~t~ fodf ~sDpeDc,ion <br /> I ~~J <br /> <br /> 3. Street Adtlress 11. State Permit Numbe ~ 1+~ <br /> d ~ <br />~~LL~~L ~ T <br /> 4. City 5. Slate t2 Yame of Mine <br /> <br />m __ ~~ ~~ TT <br />~~ I 1~~~~L~ <br />6. Zlp Code 7. Area Code 8. Telephone Number t3 County Cade 1a. Slate Code ItSm~Sn data <br />LJJ [6 Slflte Area Ofhce <br />17. OSM Field 18. OSM Area 19. OSM <br />Office No. Office No. Sample No. 20. Type o7 Inspechor 2t Joint Inspeclien <br />ICotle) Ves No ?: Inspector's ID <br />No. <br /> <br />23. Status 24. Type of Activity (check app bco0ie t:oaes) <br />A m Type of Permit _ _ s <br />A ILJI teep Slope <br />E ~~ An[hrar,~te <br />B m Mine Status (Code) <br />B ~ MowLLain fop Remo.al <br />p ~ <br />l <br />F <br /> <br />C Type of Facility 1Cotle) <br />m ~ <br />edera <br />Lands <br />I- <br />~~~~~~~~T~~~~ C ~ Prime Far mlantls G r 1 Indian Lands <br />LJ <br />D LJ_J__L_J_J=LJ Number of Permdted Acres D ~ Alluvial Valley Floors H ~ Other <br />E ~~, Number of Disturbed Acres <br />25. Performance S'andards (Codes) <br />InatruHlons: Intllcate compliance cotle For any standartl marketl 2 0~ 3 provide narrat rve In support This tleterm inatinn. <br />Standards That Limit the Effects to the Perm11 Area Standards That Assu•e ReGamBUOr, Ouahly antl Timeliness <br />A ~ Distance Prohibitions M ~ Topsoil Handling <br />B ~ Mining Within Permit Bountlaries N ~ Backrilliog and Grading <br />C ~ Signs antl Markers O ~ Fogowmg Reclamalron Schennle <br />D ~ Sediment Control Measures P ~ Reveyetahon Requirements <br />E ~ Design end Certiflcallon Requirements- O ~ Disposal of Excess Spoil <br />Sediment Gontrol <br />R ~ Handling of Acid or Toxic Materials <br />F ~ Effluent Llmlls <br /> <br />G ~ Surlace Water Monllorlnp S ~ Highwall Elimination <br /> T ^ Downslope Spoil Disposal <br />H ~ Ground Water Monitoring <br /> <br />I ~ Blasting Procetlures U ~ Post Mining Land Use <br /> <br />J ~ HaullACCess Roatl Design and Maintenance V ~ Cessation of Operations: Temporary <br /> W ~ Other <br /> <br />K ~ Refuse Impoundments _ _ _ _ _ _ _ _ _ __ <br />L ~ Other: Specily _ <br />Distribution: Original ~ Field Ollice, Green ~ Headquarters, Blue ~ State's Copy. Yellow ~ Inspector's Copy. Pink ~ File Copy IE ~ 76311/63) <br />