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<br />For The Following Entries, Circle The Approrpiate Choice: <br />Y = Inspecte ad n- fain 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 />C AVAILABILITY OF RECORDS........... [ Y / NA /_ N~ / R / V / B / T / S ] <br />[C] SIGNS AND MARKERS ................. [ Y )/ NA / N / R / V / B / T / S ] <br />[C] ROADS ............................. [ Y / NA / N / R,/ V / B / T / S ] <br />[CJ HYDROLOGIC BALANCE ................ [ Y / NA / N / ~Ri/ V / B / T / S ] <br />[C] BACKFILL & GRADING ................ [ Y / NA / N / R~/ V ! 6 1 T / S ] <br />[C] EXPLOSIVES ........................ [ Y / NA / N / R / V / B / T / S ] <br />[C] PROCESSING WASTES ................. [ Y / NA, / N / R / V / B / T / S ] <br />[C] SUPPORT FACILITIES ................ [ Y / NA / N / R ,/ V / B / T / S ] <br /> <br />[C] <br />TOPSOIL ........................... <br />[ <br />Y <br />/ <br />NA <br />/ <br />N <br />/ _. <br />R~/ <br />V <br />/ <br />B <br />/ <br />T <br />/ <br />S <br />] <br />[C] GENERAL MINE PLAN COMPLIANCE...... [ Y / NA / N / R./ V / B / T / S ] <br />[C] FISH & WILDLIFE ................... [ Y / NA / N j R / V / B / T / S ] <br />[C] REVEGETATION ...................... [ Y / NA / N / R,% V / B / T / S ] <br />[C] AIR RESOURCE PROTECTION........... [ Y / 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 / NA / N / 1/ <br />R V / B / T / S ] <br /> ~ <br />[C] OFFSITE SUPPORT FACILITIES........ [ Y /` NA ./ N / R / V / B / T / S ] <br />[C] RECLAMATION SUCCESS ............... [ Y / NA / N_ / R / V / B / T / S ] <br />[C] SPECIAL CATEGORIES OF MINING...... [ Y / NA / N / R / V / B / T / S ] <br />~2~ -------------------- [20 <br />------------------- Spaces <br />(3) Max] <br />- - - - - - - - - - - - - - - - - - - - <br />[C] OTHERS ............................ [ Y / Nom/ N / R / V / B / T ] <br />(1) -------------------- [20 <br />------- Spaces <br />~3~ ------------- Max] <br />- - - - - - - - - - - - - - - - - - - - <br />NOTE: [C] = Required Entry. <br />~~U <br />