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iii iiiiiiiiiiiu iii <br />999 <br />CEIti~~~ <br />Paae 1 0l t Paoea <br />United States Department of the int Mined Land For Office Use Only <br />Office of Surface Mining ~~~lamation Diw ior.,a ,b ,t <br />Mine Site Evaluation Inspection Report ~ m m <br />r r N M Balen Rayon <br />Z. Name of Permlttee <br />r_I_..I~-t p.l.~ r.l: l~t~l F-.i^t : l~t~l_il t I I <br />3. Sheet Address -~ i <br /> <br />- i r <br />_ ~ <br />a <br />.w <br />~ <br />~_ I <br />~ <br />1' <br />4. City 5. State <br />f m <br />6. Lp Coda 7. Area Code fi Tal hone Number <br /> - ~ <br /> t0. Dale o1 Imped6 <br />9. MSHA Number (V Y M M D <br />.,-iii' -~ <br />r_ . al l <br />11. Stale Permit Number <br /> ~ - <br />72. Nema of Mina <br /> r ~ <br />T3. Counry Code <br />a- <br />1 <br />S <br />ta <br />le Code 15. Strata te Aroe O11ice <br />1 <br />6 <br />. <br />S <br />I <br />a <br />' <br />T` <br />If <br />~I <br />' <br />lam- t m -- <br />-- <br />-- <br />-- <br />--~~'I <br />;;~I <br />~~~' <br />W <br />17. OSM FISW <br />OHIee No. <br />I~ flm~,~- 1S O.SM Araa <br />O~ffiq No. 1B. OSM <br />Sampl~ <br />' / r 20. Type of Inspection i1. Jo1nt Inspeclton <br />Cpde( 1 Yes No <br />~rf~T1 IT 1T-~1 IIrLylf IIL~II 72 Inepetlor'a ID <br />N~ <br />Z3. Stalu9 Z4. Type of ActlHty (check apPlkeble oozes). <br />A ~+{--' <br />~~-~4{---'r TYPe of Permtt <br />A ~ Steep Slope <br />E ~ Anthracite <br />B ~ Mtne Ststua (Cridel <br />S ~ Mountain Top Remo.al <br />F ~ Fetleral Lantla <br />C m Type of Faclllry (Coda) <br />C ~ Rime Farmlands <br />G ~ tndlan Lands <br />p ~ Number of Permitted Aeres <br />D ~ Alluvial Valley Floors <br />H ~ Other <br />E r, ~ r • r NumN•r of D4lurbed Acres <br />25. Performance Standame fCodesl <br />eralvettana: Indkale eompllance code. For any standard marked 2 or 9 provide narrative to support lhla determinatl~n. <br />Standards That Llmlt the Ellects to the Pennlt Area Standards That Assu•e RecUmation Oualily and Timeliness <br />A ^i Dlstanns hohlbitkne <br />B ~ Nlning Withln Pormil Boundarle9 <br />C a Slgna antl Markers <br />D ~ Sediment Control Meaeuran <br />E ~ Dealgn and Certillcallon Requlrements- <br /> Sedlmsnt Contml <br />F ~ Effluent UmKs <br />O ~ Surface Water Monltodng <br />K <br />L <br />M ~ Oround Watsr Monitaring <br />1 ~ Steeling Proosdures r , { _ ~. , <br />• - 'J <br />J ~ HsullAeceas Road Design and Maintenanee <br />~Refuee lmpcundmenla„ --, ._, ,y,_ <br />Other. Spxih <br />M Q Topsoil Handllnp <br />N ~ Batk!illmq and Grading <br />O ~ Fogowing Reclan,allon Schedule <br />P ~ Reregetetion Requirements <br />O ~ Disposal of Ezcess Spoil <br />R ~ Handllnp o/ Acld or Tozlc Materiels <br />5 ~ Hlghwell Elimination <br />T ~ pownalope Spoil Disposal <br />U ~ Poet Mining Land Use <br />V l~ Cessation of Operations: Temporary <br />W ~•^r Other <br />a <br />Dlstrlbutlon: Original - Fieltl Offlte, Green - Headquarters, Blue -State's Copy. Yellow - Inspeclafs Copy. Pink • Fila Copy IE - 163 (1183) <br />