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1 <br />lr, : ~ k~ `°:t~~w -wwci ~. err.. 'f. .. ... '.' a;~° i <br />. .. "{ <br />• • <br />For The Following Entries. Circle The Aoaroroiate Choice: <br />T = lnspectea ana rouna in compliance, <br />NA = Inspection Topic not applicable, <br />N =Not Inspected, <br />R = Inspected and Comments noted, <br />V =Inspected and Violations (NOV•),or Cessation Order (CO) issue <br />B = Inspected and both Comments noted & Violations or Cessation <br />Order issued, <br />T = 10 Day Notice Issued by OSM Oversight Personnel, <br />S =Sample taken and sent to the lab from analysis -describe <br />type and location of sample taken under comment section. <br />GENERAL INSPECTION TOPICS: <br />C <br />AVAILABILITY 0 R CORDS........... <br />[ Y / <br />NA / <br />N <br />/ <br />Q <br />/ V <br />/ <br />6 <br />/ <br />T <br />L <br />S ] <br />[C] SIGNS AND MARKERS ................. [ Y / NA / N / ~R / V. / B / T / S ] <br />~C] ROADS ............................. [ Y / NA / N / (QI7 V / B / T / S ] <br />[L] HYDROLOGIC BALANCE ................ [ Y / NA / N / I~ / V / B / T / S ] ~~~ <br />[c:] BACKFILL & GRADING ................ [ ~y/ NA / N / R / V / B / T / S ] <br />[(:] EXPLOSIVES ........................ [ Y / ® / N / R / V / B / T / S ] .~ <br /> I ~ <br />[C] FACILITIES ................ <br />SUPPORT [ Y / A / <br />N N / ®/ V / B / T / S ] <br />[C] TOPSOIL ........................... [ Y / NA / N / Q / V / B / T / S ] ,~ <br />[C] GENERAL MINE PLAN COMPLIANCE...... [~/ NA / N / R / V / B / T / S ] <br />[C] FISH & WILDLIFE ................... [ YC~/ NA / N / R. / V / B / T / S ] j <br />[C] REVEGETATION... [ ©/ NA / N / R '/ V / B / T / S ] i <br />[C] AIR RESOURCE PROTECTION........... [©/ NA / N / R / V / B / T / S ] ~' <br />[C] SLIDES & DAMAGE ................... [CD / NA / N / R / V / B / T / S ] <br />[C] SUBSIDENCE ........................ [ Y / ~ / N / R / V / B / T / S ] , <br /> <br />[C] <br />EXCESS SPOIL & DEVELOPMENT WASTE.. <br />[ CY)/ <br />NA / <br />N <br />/. <br />R <br />./ ,V <br />% <br />B <br />/ <br />T <br />/ <br />S ] :.:~ <br />;A <br />[C] OFFSITE SUPPORT FACILITIES........ [ Y / ~/ N / R / V / B / T / S ] ~ ~'~ <br /> <br />[C] <br />RECLAMATION SUCCESS ............... <br />[ ~/ <br />NA / <br />N <br />/ <br />R <br />/ V <br />/ <br />B <br />/ <br />T <br />/ <br />S ] :,~: <br />'~ <br />[C] SPECIAL CATEGORIES OF MINING...... [ Y / N9~/ N / R / V / B / T / S ] ~I <br /> <br /> <br /> (3) - - - - - - - - - - - - - - = - - - = - <br /> <br />[C] OTHERS ............................ [ Y / ~/ N / R / V / B / T ] `! <br /> (1) <br />-- <br />-- <br />-- <br />- <br />- <br />- <br />- <br />- <br />- [20 ICI <br /> -------- _ Spaces ' <br /> <br />(3) ---------- <br />-- <br />-- <br />- <br />- <br />- <br />- <br />- <br />- <br />Max] 1 <br />I <br />N07E: [C] = Required Entry. <br /> ar'i <br /> <br />