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<br />For The Followino Entries. Circle The Aoororoiate Choice: <br />r = inspectea ana rouna in compirance, <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 AVA LABIL TY 0 R CORDS........... [ Y /~ / N / R / U / B / T / S ] <br />[C] SIGNS AND MARKERS ................. [ d / NA / N / R / V / B / T / S ] <br />[C] ROADS ............................. [ QY / NA / N / R / V / B / T / S ] <br />[C] HYDROLOGIC BALANCE ................ [ Y / NA / N /® /~ V ,,/ B / T / S ] <br />[C] BACKFILL & GRADING ................ [ Y /~I / N / R / V / B / T / S ] <br />[C] EXPLOSIVES ........................ [ Y / N / 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 / ® / N / R / V / B / T / S ] <br />[C] GENERAL MINE PLAN COMPLIANCE...... [~/ NA / N / R / V / B / T / S <br />[C] FISH & WILDLIFE ................... [ Q/ NA / N / R / V / 6 / T / S ] <br />[C] REUEGETATION ...................... [ Y / NA / N /~/ V / B / T / S ] <br />[C] AIR RESOURCE PROTECTION........... [ Y /~ / N / R / V / B / T / S ] <br />[C] SLIDES & DAMAGE ................... [ Y / ~/ N / R / V / B / T / S ] <br />[C] SUBSIDENCE ........................ [ Y /~ N / R / V / B / T / S ] <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE.. [ Y /~/ N / R / V / B / T / S ] <br />[C] OFFSITE SUPPORT FACILITIES........ [ Y / NA / N /~/ V / B / T / S ] <br />[C] RECLAMATION SUCCESS ............... [~ / NA / N / R / V / B / T / S ] <br />[C] SPECIAL CATEGORIES OF MINING...... [ Y / ®/ N / R / V / B / T / S ] <br />(1) -------------------- [20 <br />(2) -------------------- Spaces <br />(3) -------------------- Max] <br />[C] OTHERS ............................ [ Y /~ / N / R / V / B / T ] <br />~2~ -------------------- [Spaces <br />(3) -------------------- Max] <br />- - - - - - - - - - - - - - - - - - - - <br />NOTE: [C] = Required Entry. <br />