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.- . _ _ <br />,°P Zr <br />.~• m <br />P~~`~ ~"_~e" U. S. DEPT. OF THE INTERIOR ~~~ ~~~~~j~l~~~~~~~~ <br />y <br />° ~ OFFICE OF SURFACE t NAND ENFORCENi>+;N't':~~ s9 z~ <br />~4q~M ~~~a•° Mine-Site Ev~ ' I lion Report c~~~. <br />1. PermitteeJPerson Utli 1 9yPe~nit Number 10. Type <br />a Pemtit b. IiA <br />N L5. Co ~ DVI I N - -614 <br />2. Address RALS & ~3~~sdf1 Date~m~.~ X12. Inspection Type 13. Joint Inspection <br />m-®-17.151 ~ © Y!N <br />MM - 00 - rr <br />3. Ci[y 4. State I4. Permit Status 15. Site Status 16. Facility Type <br />~ ~ Ca ~ ® CE <br />5. Zip Code 6. Phone Number 17.OSM Office # 18. RSI # 19. Land Code <br />L~Ll1~LZJ~1-~ ~-®- (03 <br />7.Operator if Different than Permitlee 20. M.S.FLA. ID # 21. State Code 22. County Cade <br /> ~ <br /> <br /> 8. Mine Name 23. AVS Permittce Entity ID Number <br /> t <br />-. (o f <br />- <br />24. Performance Standard Categories -- ~ -- <br />Codc-• 1=Compliance, 2=Noncompliance, 3=Not Planned, 4=Not Started, 6=Noncompliance Identified Elsewhere <br />A. P.: .'nistrative D. Backfining & Grading H. Subsidence Control Plan <br />i. ~ 4inittg within Valid Permit 1.~Exposed Openings L Roads <br />2 .:itning within Bonded Area <br />3._ r 'ems & Conditions of Permit 2 1 Contemporaneous Reclamation <br />3.~,Approximate Original Contotu <br />- 1.1Road Constrncdon <br />4._ :.lability Insurance 4,~Flrghwall Elimination 2 ~ Certifittatiton <br />Drainage <br />3 <br />5. ~ Ownership and Cootml <br />Ttxnporary Cessation <br />6. <br />I 5. 3 Steep Slopes (includes downslope) <br />6.! Handling of Acid & Toxic Materials .~ <br />4._Surfadng and Maintenance <br />,_ <br />_ 7.~Stabili7ation (rills and gullies) 5.1Rxlamation <br />B. Hydrologic Balance <br />1.! Drainage Control <br />& Excess Spoil Disposal <br />J. Signs & Markers <br />2 ~ Inspections & Certifications 1.~Placement 1.~Sigrtt <br />2 <br />L~Rs <br />3. 1 Siltation Structtues 2~Drainage Control .- <br />4.TDischarge Structures 3,~Stuface Stabilization [G ~Distaace Prohibitions <br />5. f Diversions 4.~Inspections & Certifications <br />6, f Eftluwt LimiCS <br />7,! Cuound Water Monitoring <br />F. Coal 14Tine waste <br />" L. Rev elation <br />1~Vegetative Cover <br />8.! StafaaWatvMonitoriag ilesl]tnpouadments) <br />(Refuse P 2.~Timing <br />9,! Drainage -Acid-Toxic h:aLerials 1.~Drainage Control <br />10. 1 Impoundments 2,_)__Strrface Stabiliration M. gPtutmiaing Iaad Use <br />11.~Stream Buffer Zones 3~. PlaCeme°t <br /> 4 / Irtsnections and Certifications N. Other <br />C. Topsoil & SabsorT <br />; 5,.,~mpounding Structures 1) <br />1,_J_Removal <br />2.~Sttbstitufe Materials ': G. Use Of Explosjv~ _ <br />3. f S;nrage and Pmtectioa ~ 1~Blaster Certification _2) <br />4, 1 Rndistrfbuuan 2.~Distanrti irrOhibifious <br /> 3,1' BhtstSurvey/Schedule 3) <br /> 4.~Wamings & Records - <br /> S~Control of Adverse Effects <br />25. Inspet*ion Frequency 26. Inspection Hours <br />aouewtast ®-®-® <br />Sta<e Complete <br />Ytaperbon <br /> <br />a Permit Review <br />® <br />~ <br />FKquenel for predoaa { Calendar Qua . <br />hNambeol Nambrtof ~ <br />ooo~lete <br />complete iarpecaoos <br />D <br />~ ®.~ b. Inspection Time <br />~~~ ~~~ ~ rn Travel Time <br />() ~ <br />e Number of Nombcr of <br />~ g <br />~ <br />O°' <br />l ~ <br />rt W <br />i <br />i <br />® <br />®d R <br />m <br />specC <br />'ons ~a~d ~ ? , epo <br />t <br />r <br />ng <br />;7. Bonded Acres <br />a Total <br />~.a b~ <br />b. Phase I <br />O O , D released <br />~• ~ G Phase II <br />released <br />~.~d. Phase IIl <br />released <br />28. Acres <br />0282 ~ ,© a~""`d <br />~ <br />D D b. Disturbed <br />, (Ertimated) <br />Page 1 of <br />