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<br />,. ` ~; U S; DEPT. OF.THE IN'1~RIOR''' "' <br />OFFICE OF SURFACE MINING RECLAMATION AND ENFORCI <br />Mine-Site Evaluation Inspection Report <br />1. <br />2. Address <br />9. Permit Number <br />-Sl-oi <br />1 [.Inspection Date l2. Inspection Type <br />-I 9-9 I <br />nIf DD ry <br />3. City 4. State 14. Permit Staves 15. Facility Type <br />Gone ® ® m <br />5. Zip Cade 6. Phone Nttmher 17.OSM Office # 18. RSI # <br />1 G 03-78 -G39 OZ <br />7.Opetator if Different than Permittee 20. M.S.H.A. ID # 21. State Code <br />05-035' ~. <br />8. Mine Name <br />10. Permit Type <br />I3. Joint Inspection <br />YEN <br />16. Producing Coal <br />a YEN <br />19. Land Code <br />22 County Code <br />23. Performance Standard Categories <br />Codes: l=Compliance, 2=violation, 3=Not Applicable <br />A. Administrative D. Backfilling & Grading H. Subsidence Control Plan <br />I. ~ Valid Permit 1.~Exposed Openings <br />2. 2 Mining within Bonded Area 2.LContemp. Reclamation L Roads <br />3.? Terms & Conditions of Permit 3.! Approx Orig. Conwur 1. 3 Const Cent <br />4. ~ Liability Insurance 4.3 Highwall Elimination 2. Z Drainage <br />5. Z Ownership and Control S..~Steep Slopes 3.LSurfacing <br />6. ! Pemtit Defect 6.3 Handling of Acid & Toxic Materials 4. t Maintenance <br />7..LStabili~ation (rills and gullies) S.~Rxlamation <br />B. Hydrologic Balance <br />1.2 Drainage Control <br />2.~Inspections & Ceps. <br />3.? Siltation Strucwres <br />4.~Discharge Strucwres <br />S.~Diversions <br />6. ~ Effluent Limits <br />7.! Ground Wate: Monitoring <br />8. ~ Surface Water Moniwring <br />9. 3 Drainage -Acid-Toxic Materials <br />lU.? Impoundments <br />1 l.,~Stream Buffer Zones <br />C. Topsoil & Subsoil <br />1. / Removal <br />2.3 Substiwte Materials <br />3. / Swrage <br />4. / Redistribution <br />E. Excess Spoil Disposal <br />1.3 Placement <br />2.~Drainage Control <br />3.~Stuiace Stabihration <br />4..? Inspections & Certification <br />F. Coal Mine Waste (Refuse Piles/Impoundments) <br />1. Z Drainage Control <br />2.LSurCace Stabifiration <br />3. 2 Placement <br />4. ~ Inspections and Certification <br />5. 3 Impounding Swcwres <br />G. UseOCExplosives <br />1.3 Blasttx Certification <br />2.3 DISLMCC Prohibitions <br />3.3 Blast Survey/Schedule <br />4.~Wamings & Records <br />S.LControl of Adverse Effects <br />J. ~ Signs & Markers <br />K.! Distance Prohibitions <br />L. Revegetation <br />L.L.Vegetative Cover <br />2.~Timing <br />M. I Protection oI Fish & Wildlife <br />N. Other <br />_1) <br />_2) <br />24. OSM Action <br />b. TDN #X ]~-pa-~-QOl TV ~ <br />c.NOV11N===_ TV <br />d. CO NC==_ TV_ <br />25. Ins ection Hours <br />z o .~ a. Pemut Review <br />d L ,~ b. Inspection Tune <br />~.~~] c. Travel Time <br />3 O a d. Report Writing <br />26. Acres <br />O g Z ! ,~ % Permitted <br />Q Q Q ,rj ~Q b. Disturbed <br />Page 1 <br />