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For the Following Entries, Circle the Appropriate Choice: Y = Inspected and Found in Compliance NA = Inspection Topic Not Applicable N = Not Inspected R = Inspected and Comments Noted V = Inspected and Violations (NOV) or Cessation Order ICOI Issued B = Inspected and Both Comments Noted and Violations or Cessation Order Issued T =Ten-Day Notice Issued by OSM Oversight Personnel S = Sample Taken and Sent to the Lab for Analysis (Describe type and location of sample taken under Comment section.) GENERAL INSPECTION TOPICS: [C] AVAILABILITY OF RECORDS ................ Y / NA / ®/ R / V / 8 / T / S [C] SIGNS AND MARKERS .................... Y / NA / ®/ R / V / B / T / S IC] ROADS .............................. Y / ~ / N / R / V / B / T / S [C] HYDROLOGIC BALANCE ................... Y / NA / N / ~ / V / B / T / S [Cl BACKFILL & GRADING .................... 4~ / NA / N / R / V / B / T / S [CI EXPLOSIVES ........................... Y / ~ / N / R / V / B / T / S IC] PROCESSING WASTE .................... ~ / NA / N / R / V / B / T / S [C] SUPPORT FACILITIES ..................... Y / ~ / N / R / V / B / T / S ICl TOPSOIL ............................. Y / NA / ~ / R / V / B / T / S [C] GENERAL MINE PLAN COMPLIANCE .......... ~ ! NA ! N / R / V / B / T / S IC] FISH & WILDLIFE ........................ Y / NA / ~ / R / V / B / T / S lC] REVEGETATION ........................ Y / NA / N /~ / V ! B / T / S [C1 AIR RESOURCE PROTECTION ............... Y / NA /~/ R / V / B / T / S 1C] SLIDES & DAMAGE ...................... Y / NA / N /~i'j/ V / B / T / S [C] SUBSIDENCE .......................... Y / NA / N /®/ V / B / T / S IC] EXCESS SPOIL & DEVELOPMENT WASTE ...... Y / NA / ®/ R / V / B / T / S ICI OFFSITE SUPPORT FACILITIES .............. Y / NA /®/ R / V / B / T / S [CI RECLAMATION SUCCESS .................. Y / NA / N / (~ / V / B / T / S [C] SPECIAL CATEGORIES OF MINING .......... . Y / I®/ N / R / V / B / T / S 111 - ------= -- -- - - - 121 - ------ -- --- - - 131 - - - - - - - - - - - - - - - - - - (Cl OTHERS ............................. . Y / ~ / N / R / V / B / T 111 - - - - - - - - - - 121 --- - - - -- - - - 13)