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Paee Z of 3 Paaea <br />}.` <br />United States Department of the Interior <br /> Office of Surface Mining `~,~`' <br /> Mine Site Evaluation Inspection Report <br />ffi Sate Perrrlil Number 27. Date of Inspection <br /> (YYMMD D) <br /> <br />?B. Yy No Do mining and reclamation activities on the site comply with the plans in the permit? <br />H ^ If no, Ida nartative to su ort this determination. <br />Z8. Indcate number of complete and partial Inspections conducted by the State to date for this annual review period: <br />?ea ~ Number of Completes 29b. ~ Number of Partials ~ ~ /; <br />r. <br />30. Indicate number of complete and partial Inspections required Dy the State during this annual review period: <br />30a ~~. Number of Completes 30b. ~-Number Of Partials <br />31. Has Inspection frequency been met? <br />Yea No Yes No <br />31a © ^ Compotes 31 b. ^ ^ Partials <br />32. FEDERAL ENFORCEMENT INFORMATION. [Enter violation number. Check appropriate box(es)) <br />Ten-0ay Notice No. Notice of Violation No. Cessation Order No. Violation Codes <br />A ^ ^ ^ Authorizations to Operate <br />6 ^ ..................... ^ ...... ............... ^ ........................ Signs and Markers <br />C ^ ..................... ^ ...... ............... ^ ........................ 6eckfilling and Grading <br />D ^ ..................... ^ ...... ............... ^ ........................ Highwall Elimination <br />E ^ ..................... ^ ..... ............... ^ ........................ Rills and Gulllea <br />F ^ ..................... - <br />^ ^ Improper Fills <br />G^ ^ ^ Topsoil Handllnp <br />N ^ ....-------~--•--.... ^ ...... ............... ^ ........................ Sediment Ponds <br />t ^ -...........'-....... ^ ...... ............... ^ ........................ Effluent Limits <br />~ ^ ..................... ^ ...... ............... ^ ........................ Water Monitoring <br />K ^ ^ ^ ........................ Buffer Zones <br />~ ^ -------------~--~~--. ^ ...... ............... ^ ........................ Roads <br />M ^ ..................... ^ ...... ............... ^ ........................ Dams <br />N ^ ..................... ^ ...... ............... ^ ........................ Blasting <br />O ^ ^ ^ ........................ Revegetation <br />P ^ ^ ^ .......... . . . .... . . . . . .. SPOiI on the Oownslope <br />O^ ^ ^ Mining Without Permit <br />R ^ ^ ^ ........................ Exceeding Permit Umits <br />S ^ ^ ^ Distance Prohibitions <br />T ^ ^ ^ Toxic Materials <br />~ ^ ..................... ^ ...... ............... ^ ........................ Other Violations <br />33 Hama of AuMorized Representative (print or type) <br />. ~ 4 f <br /> <br />Sigrlatwe of Autl~o ixsd9@preaentatlve <br />Date . - <br /> <br />Signature otJieviewing Official .Date ~ ~ - _ <br />~~~ ,~~. ~ T. ]. - <br /> <br /> <br />~~ <br />Dia6lblAion Original -Field Otflce, Green -Headquarters, Blue -Slate's Copy, Yellow -Inspector's Copy,.Pink -File Copy IE - 163 (11691 <br />