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For The Following 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) or Cessation Order (CO) issued, B =Inspected and both Comments noted & 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 ana location of sample taken under comment section. GENERAL INSPECTION TOPICS: CORDS........... L Y / NA / R / V / B / T / S ] LCJ SIGNS AND MARKERS ................. L Y / NA / N / R / V / B / T / S ] lCJ ROADS ............................. L Y / NA N R/ Y / B / 7 / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N /~ V / 8 / T / S ] LCJ BACKFILL & GRADING ................ L Y / NA / N ~ V / B / T / S J LC] EXPLOSIVES ........................ L Y / N N/ R/ V / B / T / S ] LC] PROCESSING WASTES ................. L Y / A N/ R/ V / B / T / S J LCJ SUPPORT FACILITIES ................ L Y NA / N / R / V / B / T / S ] LCJ TOPSOIL ........................... L Y / NA /~ / Y / B / T / S ] LC] GENERAL MINE PLAN COMPLIANCE...... L Y / NA / N ~ V / B / T / S ] LCJ FISH & WILDLIFE ................... L Y / NA ~ // ~~ /~pLy R / V / B / T / S ] LCJ REVEGETATION ...................... L Y / NA / N R / V / B / T / S ] LCJ AIR RESOURCE PROTECTION........... L Y / NA N R / V / B / T / S ] LCJ SLIDES & DAMAGE ................... L Y / NA / N ~ V / B / T / S ] LCJ SUBSIDENCE ........................ L Y / NA N / R / V / B / T / S ] LCJ EXCESS SPOIL & DEVELOPMENT WASTE.. L Y / NA / N / R / V / B / T / S ] LCJ OFFSITE SUPPORT FACILITIES........ L Y /~.~ N / R / V / B / T / S ] LCJ RECLAMATION SUCCESS ............... L Y / N. ~/ R / V / B / T / S ] LC1 SPECIAL CATEGORIES OF MINING...... L Y ~/ N / R / V / B / T / S ] (2) -------------------- L2SPdceS (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y /~ / N / R / V / B / T ] (2) -------------------- LSpaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - NOTE: LCJ = Required Entry.