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ioc ument 1127E MMADE OI Cr!AL NiIIICE GF VIOL A.f U]N CO L'iNG FORM ___C_~________________________________ C] VIOLATION NUM EER........... C - / ~_ - z- 9 :Cl MINE OR E;(F U7RATION IU d... C - ~ ~ - ~ ~ ~` __ __ __ __ __ __ __ CATEGORY OF VIOLATION ..... V ~/~'~ 'C] INS FECTI r!N DATE............ ~_ ~ /__\/ _ S_~ VIOLATION TOPICS VIOLATION_T OP ICS H /3 'C] PRIMARY TOPIC..... _ __ SECONDARY TOPIC.... lCL-IE* AD=Administrative, AP=Air Resource Pro to ctian, AR=Availability of Records, BG=BackFill my 8 6r ading CR=Contemporaneous Reclamation, ES=Excess Spoil 3 Dev. Waste, EX=Explosives, FW=Fish 8 Wildlife, HB=Hydrologic Balance, HM=Hydrologic Monitoring, MF=Gen. Compliance With Plan, PW=Processing Waste, DATE ISSUED ................... _~ __ v, 3 I / GI -- Revised 10/°'~ TERTIARY TOPIC.... __ __ RD=Roads, RS=Reclamation Success, RV=R eveyetation, SB=Subsidence, SC=Sediment Control, SU=Slides S Other Dam aye, SF=Support Facilities On-site, SM=Signs S Markers, SN=SupVart Facs, Not On-site, SP~=Special Categories of Mining, TS=Topsoil, OR=Other) DATE OF UN-SITE HEART NG....... / / VIO~~TION_ DESCRI PTION~ F A l C V R f T O Df S 7G~J d M•4/NT~Fi/l! T n_c_ __ ~~4~lUr9vF -- -=5-1 S«~ -- -- -- -- -- -- -- -- -- -- -- -- -- (50 Spaces) ABATEMENT _________ UUE DATES ___________ S _ EPARATE 0.BATEMEN7 DESCRIPTIONS _______________________________ -- -r / ~ _ ~_ / _9 L_ E_ S_ T ~ 3_ l_ (_ s ~ __ ~ ~ _s~t=-.a,~__ iN_ _R~c-_ -- "~1- - ~ ~= ~ N - -- -- - - -- -- - -- -- - -- -- -- -- - - -- - _ - - - - -- - -- -- - - -- -- -- - - -- ~ U_ Luc`~js-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- - -- -- - - - - -- - -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- (50 -- -- -- Spaces) NOTESa (1) CC] = Required entry for all Notice oP Violation rucards. OPERATOR_NOTE• Enter "NAT UkE OF Vi0LA 710N" narrative or, opposite side into "NARRATIVE EDIT" screen.