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~~ <br />P•pa + a x Pagq <br />United $t8te8 Department of the Interior For Office Use Only <br />.Office of Surtace Mining <br /> <br />Mine Site Evaluation Ihspection Report „ <br />~ ,b ,P <br />m m <br /> Y Y M M Batth Repon <br />. 1 <br />D <br />ale of <br />Inspectlan <br />0. <br />2. Name of Pormittae 9. MSHA Number (Y Y <br /> <br />r <br />~- <br />r <br />c <br />r <br />r <br />- <br />K <br />~ <br />- <br />~' <br />- K <br />` <br />f <br />T <br />~ <br />~ `~ <br />L~.~~LY--J <br />3. Sheet Atltlresa 11. State Permit Number <br /> <br />4. Clry <br />8. S <br />t <br />a <br />te 12. Name of Mlne <br /> ~- ~ <br />T~ <br />~ <br />^ <br />I r-I - r r . /' r - J r ' <br />8. Zlp Code 7. Area Cotle 8. Telephone Number 13. County Code 14. State Code 15. Stra ta 18. Stele Area Office <br /> <br />17. OSM Field 18. OSM Aroe 19. OSM 20. Type of Inspection 21. Joint Inspection 22. Inspector's ID <br />OHl <br />cs No. O~tllee Ho. SamPl~ ICOde~ ~ ® N~ <br />m <br />23. Statue 24. Type of Activity (check epPllcaDle tgxea). <br />A I . l a._4 ~~ • ••~ ~ TYDe of Permit ^ <br />A Steep Slope <br />E ~ Anthraelte <br />B ® Mlne Statue lCOde) <br />B ~ Mountain Top Removal <br />F ~ Federal Lantls <br />~-~.~ <br />C I ; I., 1 Type of Facility (Codsl <br />~- ~ <br /> C ~ Prime Fermlantle G ~ Intllan Lands <br />0 ~ U • Number of Permuted Acres <br />D ~ Alluvial Valley Flooro <br />H ~ Other <br />E ~ • ; Number of Dleturbetl Aaes <br />25. Pertormance Slandarde (Cotlee) <br />In•bvNone; Intllcate compllenG cotls. For any etandartl marketl 2 or 3 proYltle narrative to suPPPA this determinatlan. <br />Stantlertls Thal Llmlt the Eflects 1o the Permit Aroa Standards That Aaeura Reclamallon Ouallty antl Tlmellneae <br />A © Distance ProhllNtlon9 M ~ Topsoil Hantlllnq <br />B ~ Mlnlnq Wlthln Permit Bountlarlea N"~T/ I Backflllinq antl Gradlnq <br />~ <br />C ~ Slgna and Msrksra ~ Following Reclamation Schedule <br />O <br />D ~ Setllment Control Measures P ~ Revegatatlon Requirements <br />E © Dealgn and CMIfIGtlon Requirements- O ~ Disposal of Excess Spoil <br />Sstlimsnt Control <br />R ©Hantlllnp of Acltl or Toxic Materiels <br />F ~ Effluent Llmlta <br /> <br />G ~ SuAace Water Monitoring S ~ Highwall Ellminatlon <br /> <br />N ~ Glountl WatN Monitoring T ~ Downelope Spoil Disposal <br /> u ~ Poet Mlnlnq Lantl use <br />I a Blutlnq Proeetlurss <br />V ~ Cesaallon of ODeratlona: Tamporory <br />J ~ HauUAPCSae Roatl Dealgn and Maintenance <br /> <br />K ~ Refuse Impoundments W ~ Other <br />L ~ Other: Specify <br /> <br />Distribution: Original - Fleltl O1fic•, Green -Headquarters, Blua -State's Copy, Yellow - Inspector's Gopy. Pink -File Copy IE - 103 (1183) <br />