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For the Foll~~,ing Entries, Circle The Appropriata Choice: = nspec e an bun to Comp Lance, NA = Inspection Topic not applicable, N = Nit Inspected, R =Inspected and Comments noted, Y =Inspected ana Violations (NOV) or Cessation Order (CO) issued, B = Inspected and both Comments noted B 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 /~ R / V / B / T / S J LCJ SIGNS AND MARKERS ................. L Y / NA / N / R / V / B / T / S J LCJ ROADS ............................. L Y / NA / N / R / V / B / T / S LCJ HYDROLOGIC BALA.NCE ................ L Y / NA / N / R / 4 / B / T / S LCJ BACKFILL & GRADING ................ L Y / NA /~ R / V / B / T / $ J LCJ EXPLOSIVES ........................ L Y / A / N/ R / V / B / T / S J LCJ PROCESSING WASTES ................. L Y / NA / N / R / V / B / T / S J LCJ SUPPORT FACILITIES ................ L Y / NA / N / R / V / B / T / S ] LCJ TOPSOIL ........................... L Y / NA /~N / R / V / B / T / S J lC] GENERAL MINE PLAN COMPLIANCE...... L Y / NA ~/ R / V / B / T / S LCJ FISH & WILDLIFE ................... L Y / NA / N / R / V / B / T / S ] LCJ REVEGETATION ...................... L Y / NA / J~ R / V / B / T / S J LCJ AIR RESOURCE PROTECTION........... L Y NA / N / R / V / B / T / S J LCJ SLIDES & DAMAGE ................... I ~ / NA / N / R / V / B / T / S J LCJ SUBSIDENCE ........................ L Y / NA /~ R / V / B / T / S LCJ EXCESS SPOIL 8 DEVELOPMENT WASTE.. LOY / NA / N / R / V / B / T / S LCJ OFFSITE SUPPORT FACILITIES........ L Y / NA / N / R / V / B / T / S J lCJ RECLAMATION SUCCESS ............... L Y / NA / N / R / Y / B / T / S LCJ SPECIAL CATEGORIES OF MINING...... L Y / NA N / R / V / B / T / S J I1 ) L 20 (2) --------------------_ Spaces (3) -------------------- Max] Lr;J OTHERS ............................ L Y {'EiA 1' N/ R/ V/ B/ T J (1) ---- L20 (Z) ---------------- -- Spaces (3) -------------------- MaxJ NOTE: LCJ = Required Entry.