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' For The <br />~- <br />NA <br />N <br />R <br />V <br />B <br />T <br />S <br />Following Entries, Circle The Approrpiate Choice: <br />nspec a an oun~in comp Trance, <br />Inspection Topic not applicable, <br />Not Inspected, <br />Inspected and Comments noted, <br />Inspected and Violations (NOV) or Cessation Order (CO) issued, <br />Inspected and both Comments noted & Violations or Cessation <br />Order issued, <br />10 Day Notice Issued by OSM Oversight Personnel, <br />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 0 CORDS........... [ Y / NA / (A~ / R / V / B / T / S ] <br />[C] SIGNS AND MARKERS ................. [ Y / NA / N / ®/ 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 ................ [ Y / NA / NQ / R / V / B / T / S ] <br />[C] EXPLOSIVES ........................ [ Y / ~ / N / R / V / B / T / S ] <br />[C] PROCESSING WASTES ................. [ Y / NA / N / f~ / V / B / T / S ] <br />[C] SUPPORT FACILITIES ................ [ Q / NA / N / R / V / B / T / S ] <br />[C] TOPSOIL ........................... [ Y / NA / N /((~ / V / B / T / S ] <br />[C] GENERAL MINE PLAN COMPLIANCE...... [ ®/ NA / N / R / V / B / T / S ] <br />[C] FISH & WILDLIFE ................... [ ~/ NA / N / R / V / 8 / T / S ] <br />[C] REVEGETATION ...................... [ ~/ NA / N / R / V / B / T / S ] <br />[C] AIR RESOURCE PROTECTION........... [ Y / NA / N / ®/ V / 8 / T / S ] <br />[C] SLIDES & DAMAGE ................... [ Y / ~ / N / R / V / B / T / S ] <br />[C] SUBSIDENCE ........................ [ Y / NA /~ / R / V / B / T / S ] <br />[C] EXCESS SPOIL & DEVELOPMENT WASTE.. [ Y / NA / N /®/ V / B / T / S ] <br />[C] OFFSITE SUPPORT FACILITIES........ [ Y / f~9 / N / R / V / B / T / S ] <br />[C] RECLAMATION SUCCESS ............... [ m/ NA / N / R / V / B / T / S ] <br />[C] SPECIAL CATEGORIES OF MINING...... [ Y / ®/ N / R / V / B / T / S ] <br />(1) [20 <br />- - - - - - - - - - - - - - - - - - - - <br />(2) -------------------- Spaces <br />(3) -------------------- Max] <br />[C] OTHERS ............................ [ Y /® / N / R / V / B / T ] <br />(1) -------------------- [20 <br />~3~ -------------------- SpaMax] <br />- - - - - - - - - - - - - - - - - - - - <br />NOTE: [C] = Required Entry. <br />