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For The Following 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 and Violations (NOV) or Cessation Order (CO) issued, B =Inspected and both Comments noted & Violations or Cessation Order 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 /(.DV / R / V / B / T / S ] LCJ SIGNS AND MARKERS ................. L Y / NA / N /~/ V / B / T / S ] LCJ ROADS ............................. L~/ NA / N / R / V / B / T / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N /~/ V / B / 7 / S J LCJ BACKFILL & GRADING ................ ~/ NA / N / R / V / B / T / S J LCJ EXPLOSIVES ........................ L Y /~/ N / R / V / B / T / S J LCJ PROCESSING WASTES ................. L Y / ~/ N / R / V / B / T / S LCJ SUPPORT FACILITIES ................ L Y /~/ N / R / V / B / T / S J LCJ TOPSOIL ........................... L Y! NA / N 1 R 1 V / B 1 T 1 S LCJ GENERAL MINE PLAN COMPLIANCE,,,,., L Y / NA / N / R / V / B / T / S LCJ FISH & WILDLIFE ................... ~/ NA / N / R / V / B / T / S ] LCJ REVEGETATION ...................... ~/ NA 1 N / R 1 V / B f T 1 S ] LCJ AIR RESOURCE PROTECTION........... L Y /~/ N / R / V / B / T / S J LCJ SLIDES & DAMAGE ................... l Y / / N / R / V / B / T / 5 J LCJ SUBSIDENCE ........................ L Y / NA /~/ R I V / B / T / S J LCJ EXCESS SPOIL & DEVELOPMENT WASTE.. L Y / J~/ N / R / V / B / T / S ] LCJ OFFSITE SUPPORT FACILITIES........ L Y /~ / N / R / V / B / T / S J LCJ RECLAMATION SUCCESS ............... L Y / NA / N /® / V / B / T / S ] LCJ SPECIAL CATEGORIES OF MINING...... L Y /~/ N / R / V / B / T / S J (2) -------------------- L2Spaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - Lf.J OTHERS ............................ L Y! NA ! N~ V! 6/ T J (2) pQa~ge.~ExC~ ------------- LSpaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - NOTE: LCJ = Required Entry.