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T For The Following Entries, Circle The Appropriate Choice: = nspec a an oun to comp Lance, NA = Inspection Topic not applicable, N =Not Inspected, R =Inspected and Comments noted , V =Inspected and Violati ons (NO V) or Cessation Or de r (CO) issued, B =Inspected and both Comments noted & Violations o r Cessation Order issued, T 10 Day Notice Issued by OSM Oversi ght Personnel, S =Sample taken and sent to the lab f rom anal ysis - describe type and location of sample taken under,cortmen t section. ~ GENERAL INSPECTION TOPICS: +~~ CORDS........... L Y / NA /~/ R/ V/ B / T / S LCJ SIGNS AND MARKERS ................. L Y / NA / N / ~/~/ B / T / S J LCJ ROADS ............................. L O/ NA / N / R / V / B / T / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N /~R / V / B / T / S LCJ BACKFILL & GRADING ................ L Y / NA / N /~/ Y / B / T / S LCJ EXPLOSIVES ........................ L Y / ~/ N/ R/ V/ B / T / S LCJ PROCESSING WASTES ................. L Y / / N / R /~/ B / T / S ] LCJ SUPPORT FACILITIES ................ L Y ~ / A / N/ R~1' V/ B / T / S J LC] TOPSOIL ........................... L Y / NA / N / ~/~/ B / T / S J LCJ GENERAL MINE PLAN COMPLIANCE,,,,,, L Y / NA /(f~J / R / V / B / T / S J LCJ FISH & WILDLIFE ................... L Y / NA / / R / V / B / T / S LCJ REVEGETATION ...................... L Y / NA / ©/ R / V / B / T / S J LCJ AIR RESOURCE PROTECTION........... L Y / ® / N / R / V / B / T / S J LCJ SLIDES & DAMAGE ................... L Y / NA /~/ R / V / B / T / S ] LCJ SUBSIDENCE ........................ L Y / NA / ~/ R / V / B / T / S J LCJ EXCESS SPOIL & DEVELOPMENT WASTE.. L Y / ~ / N / R / V / B / T / S ] LCJ OFFSITE SUPPORT FACILITIES........ L Y /(((~~~"` / N / R / Y / B / T / S J LCJ RECLAMATION SUCCESS ............... L Y / / N / R / V / B / T / S ] LCJ SPECIAL CATEGORIES OF MINING...... L Y ~ / N / N / R / V / B / T / S (1) L20 (2) -------------------- Spaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y/ NA / N/ R/ Y/ B/ T J (1) L20 (2) -------------------- Spaces (3) -------------------- MaxJ - - - - - - - - - - - - - - - - - - - - NOTE: LCJ Required Entry.