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t <br />A <br /> For The Follo.~in_ 9stCircle The ADproDriate Choice; <br /> • nsp?c a en oun n compTlence, <br /> NA • Inspection Topic nat appltcnble, <br /> N NFL inspected, <br /> R. ~ Inspected and Comments noted, <br /> "'Y lnspectad and Viol <br />' ations (NOY) ur Cessation Order (CO) Issued, <br /> B Inspected ana both Comments no tea 6 V iol ations dr Cessation <br /> ' Order issued, <br /> <br />. T~~• 10 Day Notice Issu _ <br />ed by QSN Oversight <br />Personnel, <br /> • S ~• Sample taken and s ent to the lah from anal ysts - describe <br /> type and location of sample taken under comment s ection, <br />GENERAL INSPECTION TOPICS: <br /> CORDS........... L Y / NA / N / R V / B /.T , / S ] <br />LC] SIGNS AND MARKERS .............:... L Y / NA / N R / V / B / T / S ] <br />LC] ROADS ...... ........................ L Y / NA / H / R V / B / T / 5 ] <br />LCJ HYDROLOGIC BALANCE..:...:.......,... ~ Y / Na / N / R Y. / B / T / S.] <br />LC7 BACKFILL E GRADING ...........:...: L~ NA / N / R / V / 8 / T / S~] <br />lC] EXPLOSIVES ........................ L Y / NA / N / R / Y / 8 / T / S ] <br />LC] PROCESSING NASTES ................. L Y /~ N / R / Y / @./ <br />T / S ] <br />LC] SUPPORT FACILITIES ................ L Y / NA / N / R <br />~ Y / , <br />B / 7 / S <br />lC] TOPSOIL ........................... L Y / NA / N / V / B / T / S ] <br />LC] GENERAL MIRE PLAN COMPLIANCE....., l~ NA / N / R / Y / B / T / S ] <br />LC] FISH 8 MILDLIFE ................... L'Y NA / N / R / Y / B / T / S ] <br /> <br />LC] REVEGETATION ...................... l Y / NA / N / 0. / V / B / T / 5 ] <br />LC] AIR RESOU0.CE PROTECTION.........,, l Y 1 NA / N / R / V / 8 / T / 5 ] <br />. LC] SLIDES i DAMAGE ................... Y / NA / N / R / Y / B./ T / 5 ] <br />LC] SUBSIDENCE........,., ............. Lam/ NA /~N / R / V / B / T / 5 ] <br />LC] EXCESS SPOIL i DEVELOPMENT NASTE.. l Y / NA / H ~/ V / B / T / 5 ] <br /> <br />LL1 OFFSITE SUPPORT FACILITIES........ L Y / ®/ H / R / Y / B / T / S ] <br /> <br />LC] RECLAMATION SUCCESS ............... ~~/ NA / N / R / Y / 8 / T / S ] <br />LC] •SPECIAL CATEGQRIES OF M~NING,. <br />..., L Y ~ N / 0. / Y / B / T / S ] <br /> • <br />. .. .~ <br />. <br />, <br /> I1) L20 <br /> {Z)------------_ _._.._--- - -- Spaces <br /> (31 _ ._ ~._ - _ _. _ - _. - _ .r - ^ _ _ _ _ .~ Max] <br />lC1 OTHERS.......^....~.... .... L Y / NA / N /~ Y / e / T ] <br /> (1) P~ <br />~~~Q <br />~~ <br />L~ T <br />- Leo <br /> . <br />_ <br />. <br />(2) _'"'_"_'• - _ '_" Spaces <br /> (3) ~-...._______.... _-_-__._ ... ... _.r. Max] <br />NOTE: LC] Required Entry, <br />.~... <br />