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<br />,_ <br /> <br />For The Following Entries, Circle The Approrpiate Choice: <br />Y =Inspected and found 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 />6 =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 AVAILABILITY OF RECORDS........... [ Y / NA / N / <br />/ V / B / T / S ] <br />[C] SIGNS AND MARKERS ................. [ Y / NA / N ~ <br />/ R / V / B / T / S ] <br />[C] ROADS ............................. [ Y / NA / N / ©' V / B / T / S ] <br />[C] HYDROLOGIC BALANCE ................ [ Y / NA / N /®/ V / B / T / S ] <br />[C] BACKFILL & GRADING ................ [~/ NA / N / R / V / B / T / S ] <br />[C] EXPLOSIVES ........................ ( Y / NA / N / R / V / B / T / S ] <br />[C] PROCESSING WASTES ................. [ Y / A / N / R / V / B / T / S ]..- <br />[C] SUPPORT FACILITIES ................ [ Y / NA / N /~ V / B / T / S ] <br />[C] TOPSOIL ........................... [ Y / NA / N / R / V / B / T / S ] <br />[C] GENERAL MINE PLAN COMPLIANCE...... [ Y / NA / N / R / V / B / T / S ] <br />[C] FISH & WILDLIFE ................... [ Y / NA / N /® / V / B / T / S ] <br />[C] REVEGETATION ...................... [ Y / NA / N ~R / V / B / T / S ] <br />[C] AIR RESOURCE PROTECTION........... [© / NA / N / R / V / B / T / S ] <br />[C] SLIDES & DAMAGE ................... [OY / NA / N / R / V / B / T / S ] <br />~C] SUBSIDENCE ........................ [ Y / NA / N /®/ V / B / T / S ] <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE.. [ Y / NA / N ~R / V / B / T / S ] <br />[C] OFFSITE SUPPORT FACILITIES........ [ Y / NA / N / R / V / B / T / S ] <br />[C] RECLAMATION SUCCESS ............... [OY / NA / N / R / V / B / T / 5 ] <br />[C] SPECIAL CATEGORIES OF MINING...... [ Y / NA / N / R / V / B / T / S ] <br />.r <br />~2~ -------------------- [ZSpaces <br />- - - - - - - - - - - - - - - - - - - <br />(3) -------------------- Max] <br />[C] OTHERS ............................ [ Y / NA / N / R / V / B / T ] <br />~z~ -------------------- [Spaces <br />(3) -------------------- Max] <br />NOTE: [C] = Required Entry. <br />