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<br /> <br /> <br />For The Following Entries. Circle The Approrpiate Choice: <br />Y = inspectea ana round 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) issued, <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 AVAIA LTYO CORDS........... [4Y/ NA / N / R / V / B / T / S ] <br />[C] SIGNS AND MARKERS ................. [ D/ NA / N / R / V / B / T / S ] <br />[C] ROADS ............................. [ Y / NA / N / ® / V / B / T / S ] <br />[C] HYDROLOGIC BALANCE ................ [ Y / NA / N / R / V /~/ T / S ] <br />[C] BACKFILL & GRADING ................ [ Y / NA / N / ®/ V / B / T / S ] <br />[C] EXPLOSIVES ........................ [ 16 / NA / N / R / V / B / T / S ] <br />[C] PROCESSING WASTES ................. [ Y /~/ N / R / V / B / T / S ] <br />[C] SUPPORT FACILITIES ................ [O/ NA / N / R / V / B / T / S ] <br />[C] TOPSOIL ........................... [ Y / NA / N / R / V / ®/ T / S ] <br />[C] GENERAL MINE PLAN COMPLIANCE...... [O / NA / N / R / V / B / T / S ] <br />[C] FISH & WILDLIFE ................... [©/ NA / N / R / V / B / T / S ] <br />[C] REVEGETATION ...................... [ Y / NA / N /® / V / B / T / 5 ] <br />[C] AIR RESOURCE PROTECTION........... [~ / NA / N / R / V / B / T / S ] <br />[C] SLIDES & DAMAGE ................... [ Y / NA / N /Q / V / B / T / S ] <br />[C] SUBSIDENCE ........................ [ Y / ®/ N / R / V / B / T / S ] <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE.. [~/ NA / N / R / V / B / T / S ] <br />[C] OFFSITE SUPPORT FACILITIES........ [O / NA / N / R / V / B / T / S ] <br />[C] RECLAMATION SUCCESS ............... [ Y / NA / N /® / V / B / T / S ] <br />[C] SPECIAL CATEGORIES OF MINING...... [ Y /~/ N / R / V / B / T / S ] <br />(1) [20 <br />- - - - - - - - - - - - - - - - - - <br />2 _ <br />------------------- Spaces <br />(3) Max] <br />- - - - - - - - - - - - - - - - - - - - <br />[C] OTHERS ........................:... [ Y / NA / N / R / V / B / T ] <br />(1) [20 <br />(Z) -------------------- Spaces <br />(3) -------------------- Max] <br />- - - - - - - - - - - - - - - - - - - - <br />NOTE: [C] = Required Entry. <br />d <br />