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III IIIIIIIIIIIII III <br />REQUEST FOR AVS COMPLIANCE CHECKS <br />Permit No: <br />Applicant <br />I~` Check: <br />C-81~~~ <br />C~ ~~~~ <br />T <br />Application Type & #: <br />MSHA Id No.: <br />Adequacy of application (within 30 days of completeness) <br />RN-Oy <br />Attach a current list of the owners and controllers for the applicant and the operators, as required <br />by Rule 2.03.4, Identification of Interests. If applicable, a list of permits held by the applicant in <br />other states, by numbers and state codes. <br />Date AVS: 5 ~ ~ / (71 at~ey OSM: ~ ~ `1 /a / <br />AVS Evaluation: !~, ~~, c"J 71• , <br />OSM Evaluation: G 1/, U c~fic7Y1S <br />DMG Recommendation: d--. SSUP <br />Note: Once you get the new information back from the operator on any AVS questions or concerns, <br />please give to AVS person to make sure the concerns have been fixed and AVS can be updated. <br />2"d Check: Proposed Decision of application (3-5 days prior) <br />Date AVS: ~S ~ G Date OSM: ~6 ~? O <br />AVS Evaluation: tJu ~/io~c~"f,Gv~ <br />OSM Evaluation: No ~/, c, ~~fidv\ <br />DMG Recommendation: ~guf <br />L~ <br />3rd Check: Issuance of application (3-5 days prior) <br />Date AVS: I CL Date OSM: 1 O'Iri <br />AVS Evaluation: l ~> <br />OSM Evaluation: 1 Lt~l <br />DMG Recommendation: <br />Final Check: After Issue/Decision timeframes are over <br />Date of Issue/Decision: ~ ~~ al0 / <br />Permit Expiration: ~ / //o,~ ~y c~a <br />Permitted Acres: (n ! 2 r <br />OBI I b <br />***AVS checks are required for new permit, permit revision, permit renewal, and permit transfer/succession of <br />operator. AVS checks are also for SOAP applications and state contracts. <br />M:\coal~shart\formsVitquesl (or AVS Compliance Checks.doc <br />