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Unite hates Department of the Interior <br />. Office of Surface Mining <br />Mine Site Evaluation Inspection Report <br />26. State Permit Number 27. Date of Inspection <br /> (YYMMOD) <br />- _ <br />28. Yes No Do mining and reclamation activities on the site comply with the Dlans in the permit ? <br />Q C If no, rovitle narrative to su ort this determination. <br />29. Indlcate number of complete and partlel Inspectlons conducted by the State to date for this annual review period: <br />29a. ~ Number of Completes 29b. ~ Number of Partials <br />30. Indlcate number of complete end partlel Inspectlons required Dy the State during this annual rev iew period: - <br />%~ r <br />30a. m Number of Completes ~ 30b. m Number of Panlals =;,; .- f <br />31. Has Inspection Irequency Deen met? <br />Yes No Yes No <br />31a. ^ ^ Completes 31b. ^ ^ Partials <br />32. FEDERAL ENFORCEMENT INFORMATION. [Enter violation number. Check appraprlete box(es)] <br />Ten-Day Notice No. Notice of Violation No. Cessation Order No. Violation Codes <br />A ^ ^ <br />..................... ...... ^ <br />............... Authorizations to Operate <br />B ^ ..................... ^ <br />...... ^ ........................ <br />............... £igns and Markers <br />C ^ ^ ^ Backlllling antl Grading <br />D ~ ^ ^ Highwall Elimination <br />E ^ ..................... ^ ...... ............... ^ ........................ Rills and Gullies <br />F ^ ^ ^ Improper Fills <br />G ^ ..................... ^ ^ Topsoil Hantlling <br />H ^ ^ ^ Sediment Ponds <br />I ^ ^ ^ ........................ Effluent Limits <br />J ^ ^. ^ ........................ Water Monitoring <br />K ^ ^ ^ ........................ Buffer Zones <br />L ^ ..................... ^ ...... ............... ^ ........................ Roads <br />M ^ ..................... ^ ...... ............... ^ ........................ Dams <br />N ^ ..................... ^ ^ Blasting <br />O ^ ^ ^ Revegetation <br />p ^ ^ ^ Spoil on the Downslope <br />O ^ ^ ^ ........................ Mining Without Permit <br />R ^ ^ ^ Exceeding Permit Limits <br />S ^ ^ ^ Distance Pfohibitlone ' <br />. <br />.... <br />. <br />. <br />. <br />... <br />T ^ <br />^ ............... <br />Toxic Materials <br />. <br />. <br />. <br />... <br />........ <br />. <br />. <br />U ^ ..................... ^ ^ Other Violations <br />33. Name of Authorized Representative (prfnf or type) <br />,~_ ~ • r •. <br /> ~ ~ <br />Signature of Authorized Reprasentetlve Date <br />-_.~ <br />Signatury,of Revlewinp Official ` ~ Date <br /> <br /> <br /> <br />DlatrlDUflOrl: Orlpinal - Fls~tl Ofllce, Green - HeadQuarten, Blua - State's Copy. yellow - inapsclor'a Copy, Plnk - Flte Copy IE - 78J (1871 <br />