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For The Foll~o~ing Entries, Circle The Appropriate Choice: = nspec a an oun in comp lance, NA = Inspection Topic not applicable, N =Not Inspected, R = Inspected and Comments noted, V =Inspected and Violations (NOV) dr Cessation Order (CO) issued, B = Inspected and both Comments noted 8 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 and location of sample taken under cortment section. GENERAL INSPECTION TOPICS: CORDS........... L Y/NA/N/®/V/B /T/S] LCJ SIGNS AND MARKERS ................. LG~/ NA / N / R / Y / B / T / S ] LCJ ROADS ............................. L Y / NA / N /~ / V / B / T / S ] LCJ HYDROLOGIC BALANCE ................ L Y / NA / N / R / Q / B / T / S J LCj BACKFILL 8 GRADING ................ L Y / NA / N / ~/ V / B / T / S ] LCJ EXPLOSIVES ........................ L~ / NA / N / R / V / B / T / S j Lr=] PROCESSING WASTES ................. L Y / ~ / N / R / V / B / T / S J LCJ SUPPORT FACILITIES ................ L Y / NA / N / ®/ V / B / T / S ] LCJ TOPSOIL ........................... L Q/ NA / N / R/ V / B / T / S J LCJ GENERAL MINE PLAN COMPLIANCE...... L Y / NA / N / ®/ V / B / T / S J LCJ FISH 8 WILDLIFE ................... L Q/ NA / N / R / V / B / T / S ] LCJ REYEGETATION ...................... L ©/ NA / N / R / V / B / T / S ] LCJ AIR RESOURCE PROTECTION........... L YQ / NA / N / R / V / B / T / S J LCJ SLIDES 8 DAMAGE ................... L Y /~/ N / R/ V / B / T / S ] LCJ SUBSIDENCE ........................ L Y / ~A / N / R / Y / B / T / S ] LCJ EXCESS SPOIL & DEVELOPMENT WASTE.. L Y / NA / N / ®/ V / B / T / S J LCJ OFFSITE SUPPORT FACILITIES........ L Y / NA / N /~ / V / B / T / 5 ] LCj RECLAMATION SUCCESS ............... L C'Y~/ NA / N / R / V / B / T / S ) LCJ SPECIAL CATEGORIES OF MINING...... L Y / ® / N / R / V / B / T / S J (1) L20 (2) -------------------- Spaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - ICJ OTHERS ............................ L Y/ NA / N/ R/ V/ B/ T J (1) L20 (2) -------------------- Spaces (3) -------------------- MaxJ - - - - - - - - - - - - - - - - - - - - NOTE: LCJ = Required Entry.