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<br />• <br />For The Following Entries, Circle The A oror late Choice: <br />_ ~nspecte an oun in comp lance, <br />NA = Inspection Topic not applicable, <br />IJ =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 8, 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 AVAILABILITY OF RECORDS........... [ Y / NA ~ R / V / B / T / S ] <br />[C] SIGNS AND MARKERS ................. [ Y / NA / N ~/ V / B / T / S ] <br />[C] ROADS ............................. ~/ NA / N / R / V / B / 7 / S ] <br />[C] HYDROLOGIC BALANCE ................ [ Y / NA / N / R ~/ B / T / 5 ] <br />[C] BACKFILL & GRADING ................ [ Y / NA / N /® V / B / T / S ] <br />[C] EXPLOSIVES ........................ [ Y /~/ N / R / V / B / T / 5 ] <br />[C] PROCESSING WASTES ................. [ Y / NA / N V <br />/ R / / B / T / S ] <br />[C] SUPPORT FACILITIES ................ [ Y NA / N D <br />S <br />~'V / B / T / S ] <br />[C] TOPSOIL ........................... [ Y / NA / N ,®/ V / 8 / T / S ] <br />[C] GENERAL MINE PLAN COMPLIANCE...... ~ NA / N / R / V / B / T / S ] <br />[C] FISH & WILDLIFE ................... [ Y / NA /'~/ R / V / B / T / S ] <br />[C] REVEGETATION ...................... [ Y / NA / N /i^~R / V / B / T / S ] <br />[C] AIR RESOURCE PROTECTION........... [ Y / NA /~/ R / V / B / T / S ] <br />[C] SLIDES & DAMAGE ................... [ Y `NA / N / R / V / B / T / S <br />jC] SU°_SiDENCE ........................ [ Y tJ?,I/ N / R / V / B / T / S ] <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE.. [ Y NA / N / R / V / B / T / S ] <br />[C] OFFSITE SUPPORT FACILITIES........ [ Y /~ N' / R / V , E / T / S ] <br />[C] RECLAMATION SUCCESS ............... [ Y / NA / N R / :' / B / T / S ] <br />[C] S'rECIAL CATEGORIES OF MINlfr'G...... [ T /~'~'~/ N / R / b' / B / T / S ] <br />(1) ------------------- [20 <br />(2) -------------------- Spaces <br />(3) -------------------- Max] <br />[C] OTHERS ............................ [ Y / NA / N / R / V / B / T ] <br />~2~ -------------------- [Spaces <br />(3) -------------------- Flax] <br />- - - - - - - - - - - - - - - - - - - - <br />NOTE: [C] = Required Entry. <br />