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<br />For The Following Entries. Circle The ADOroroiate Choice: <br />~ = 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 />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 /> AVA LABILITY 0 R CORDS........... [ Y / NA /(di / R / V / B / T / S ] <br />[C] SIGNS AND MARKERS ................. [~/ NA / N / R / V / B / T / S ] <br />[C] ROADS ............................. [ L1/ NA / N / R / V / 6 / T / S ] <br />[C] HYDROLOGIC BALANCE ................ [ Y / NA / N / ® / V / B / T / 5 ] <br />[C] BACKFILL & GRADING ................ [;~ / NA / N / R / V / B / T / S ] <br />[C] EXPLOSIVES ........................ [ Y / NA / '~,~/ R / V / B / T / S ] <br />[C] PROCESSING WASTES ................. [ Y / ~ / N / R / V / B / T / S ] <br />[C] SUPPORT FACILITIES ................ [,Y / NA / N / R / V / B / T / S ] <br />[C] TOPSOIL ........................... [ Yl/ NA / N / R / V / B / T / S ] <br />[C] GENERAL MINE PLAN COMPLIANCE...... [ Y / NA / N / R /~/ B / T / S ] <br />[C] FISH & WILDLIFE ................... [CvY / NA / N / R / 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 ................... [ Y / NA )/ N / R / V / B / T / S ] <br />[C] SUBSIDENCE ........................ [ Y / NA / N / R / V / B / T / S ] <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE.. [ Y / A'/ N / R / V / B / T / S ] <br />[C] OFFSITE SUPPORT FACILITIES........ [ Y / NAB/ N / R / V / B / T / S ] <br />[C] RECLAMATION SUCCESS ............... [G / NA / N / R / V / B / T / S ] <br />[C] SPECIAL CATEGORIES OF MINING...... [ Y / NA / N / R / V / B / T / S ] <br />(1) [20 <br />- - - - - - - - - - - - - - - - - - - - <br />(2) Spaces <br />(3) -------------------- Max] <br />- - - - - - - - - - - - - - - - - - - - <br />[C] OTHERS ............................ [ Y NA / N / R / V / B / T ] <br />~z~ -------------------- [Spaces <br />(3) -------------------- Max] <br />- - - - - - - - - - - - - - - - - - - - <br />NOTE: [C] = Required Entry. <br />l <br />