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For The Following Entries, Circle The Appropriate Choice: = nsp?c a an dun in comp lance, NA = Inspection Topic not applicable, N = Nit Inspected, R Inspected and Comments noted, V =Inspected antl Violations (NOV) ur Cessation Ortler (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 co mnent section. GENERAL INSPECTION TOPICS: CORDS........... L Y / NA / ®/ R / V / B / T / S LCJ S1GNS AND MARKERS ................. L 6~/ NA / N / R / Y / B / T / S J LCJ ROADS ............................. L ~/ NA / N / R / V / B / T / S J LCJ HYDROLOGIC BALANCE ................ L ~/ NA / N / R / V / B / T / S J LCJ BACKFILL 8 GRADING ................ L~/ NA / N / R / V / B / T / S J LCJ EXPLOSIVES ........................ L Y/ ~/ N / R / V / 8 / T / S J Lr=J PROCESSING WASTES ................. L Y / Q~ / N / R / Y / B / T / S J LCJ SUPPORT FACILITIES ................ L Y / Gt~i / N / R / V / B / T / S J LCJ TOPSOIL ........................... L Y / NA /~ / R / V / B / T / S J LCJ GENERAL MINE PLAN COMPLIANCE..,.,, L m / NA / N / R / V / B / T / S LCJ FISH 8 WILDLIFE ................... L ®/ NA / N / R / V / B / T / S J LCJ REVEGETATION ...................... L ~/ NA / N / R / V / B / T / S J LCJ AIR RESOURCE PROTECTION.........,. L Y / ® / N / R / V / B / T / S LCJ SLIDES 8 DAMAGE ................... L Y/ NA /CPU/ R / Y / B / 7 / S J LCJ SUBSIDENCE ........................ L Y / NA / ~/ R / V / B / T / S J LCJ EXCESS SPOIL 8 DEVELOPMENT WASTE.. L Y / ~/ N / R / V / B / T / S J LCJ OFFSITE SUPPORT FACILIIIES........ L Y /~ / N / R / V / B / T / S J LCJ RECLAMATION SUCCESS ............... LCSf' / NA / N / R / V / R / T / S J ICJ SPECIAL CATEGORIES OF MINING...... L Y / ~ / N / R / V / B / T / S J (1) L20 (2) -------------------- Spaces (3) -------------------- MaxJ - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y/ NA / N/ R/ V/ B/ T J (1) L20 - - - - - - - - - - - - - - - - - - - = (2) SDaces (3) -------------------- Maxj - - - - - - - - - - - - - - - - - - - - NOTE: LCJ =Required Entry.