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.,~- United States department of the Interior , ~ : ' <br /> Office of Surface Mining . <br /> Mine Site Evaluation Inspection Report <br /> <br />Za Slate PamH Number .... <br />27. Date of Inapectlon ~ ~, - -~ <br />f <br />- ~ ~ ~ <br /> YMM DD <br /> ~ .2 5 -. .. <br />2a Yes - No Do minirtg and reclamation actlvltlee on the site comply with the plans In the permlt7 ~._ . <br />^ ^ If de narretlve to au ort this Oetermination. <br />2& IndMats number of complete and partial Inapectlons conducted by the State to date for this annual revlew perlod: . <br />.29a. ~ Number of Cgnplete8 ~ ~ ~ 29b. ~ Number of Partlals ~ ~ -_- - <br />3a Indlate number of complete and paAlal Inepectlons required Dy the State during this annual revlew perlod:. <br />9lh ®Number of Complatea ~ - 30D. m Number of Partlals . y yb <br />37. Has Impaction Iraquency been met? ~- <br />Yes No ~ Yes No ~ ' <br />37e. ^ Completes ~ ~ ~ 31 b. ^ Partlals <br />32. ENFORCEMENT INFORMATION. (Enter violation number: Check appropriate box(es)] <br />Tan-0ry NrAlca No. ~ Notice of Violation No. Cessation Order No. ~ Violation Codes <br />. A ^ ~_ ~~~ . .' ^ ~ ~ _ ~ ~ . ~ ^ ~ ~ ~ ~ Authorizetlone to Operate <br />9 ^ ..........~........... ^ ...... ...~............ ^ ....~ ............:....... ~ Signs and Markere <br />O ^ .........:.~.......... ^~ ...:.. ..:............ ^ ....................~.... Backfllllnp and Gradlnp <br />~ ^ ..................... ^ ...::. .........:..... - .~ Hlyhwall Ellminatlon <br />E ^ ~ . <br />.: <br />: <br />: <br />: ^ : ^ .....'......:..:..~..~..... <br />:... <br />: <br />~ ... Rills and Gullies ~~ ~.'.. <br />F ...... <br />. <br />..... <br />.... <br />. <br />.. <br />~ ~ ~ ~ .. <br />. <br />........_ <br />~ Improper Fills <br />(' ^ ................:.... ^ ...... ............:..~ ^ .............:.....~..... Topsoil Handling '~~: ', <br />H ^ .............:....... ^ ._.... :.....:........ ^:..................-...... Sediment Ponds <br />1 ^ ......... <br />...: <br />... ^ ...... ............... ^ ........................ Effluent Llmita .. <br />~ ^ .... <br />. <br />................~..... ^ ...... ............... ^ ........................ Water Monitoring <br />K^ ^ ~ ~ ^ Buffer Zones ~ ~ ~ ~-. <br />~ ^ ..........:......:.... ^ ...... ................ ^ ...........:.............. Roada ~ ~ ~. <br />M ^ ....................: ^ ... ,.. ............... ^ ........................ - Dams .. ..~ <br />N ^ ...........:......... ^ ...... ............... ^ .....................:•.. Blastlne <br />O ^ ^ ^ .. Revepetation <br />P ^ .............~........ ^ ...... ...:........... ^ .............:..:....... ~ Spoil on the Downalope <br />~ ^ ...............~...... ^ ..:... ............... ^ ........................ Mining Without Permit ..~ <br />R Exceedlrl0 Permit Llmils ~~ <br />S ^ ....................: ^ ...... ............... ^ ........................ ~ Distance Prohlbillons _ <br />T ^ ~ ^ ~ ~ ^ ~ ; : Toxic Materials <br />V ^ ...............::.... ^ ^ ........................ ~. Other Vlolatlone <br />33..Name d Aulhormed reaentative fpr/nr or type) ~ ~ ~ ~ ~ ~ - ~ ~ ~ ~ . , <br /> o-r ~ <br />~ ~ <br />~ _ <br />. <br />~ ~ ~ <br />Siprlature of Representative Date ~ ~ ~ <br />~ S <br />~~ <br /> // G D 5 0 <br /> <br />Sipnafdre of I O el ~ <br />Da e <br />. ~ ~ b _ <br />5 - <br /> <br /> <br />Pepe 3 0l t Pepn <br />DIatrWVOrc pripinel - FIeW UNles, Green - Heatlquanere, Blus -Slate's Copy, YNlow - Inepsolore Copy, Plnk • Flle Copy ~ IE • 163 (11BJ) <br />