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For The Follov,ing Entries, Circle The AoPropriate Choice: <br />= nspec a an oun to comp Lance, <br /> NA = Inspection Topic not applicable, <br /> N =Not Inspected, <br /> R =Inspected and Comments noted, <br /> Y =Inspected and Viol ations (NO V) or Cessation Order (CO) issued, <br /> B =Inspected and both Comments no ted & Violations or Cessation <br /> Order issued, <br /> T = 10 Day Notice Issu ed by OSM Ov ersight Personnel , <br /> S =Sample taken and s ent to the l ab from anal ysis - describe <br /> type and location of sample ta ken under comment section. <br />GENERAL INSPECTION TOPICS: <br /> CORDS........... LQ/ NA / N / R / V / B / T / S ] <br />LCJ SIGNS AND MARKERS ................. L Y / NA / N /®/ V / B / T / S ] <br />LCJ ROADS ............................. L ©/ NA / N / R / V / B / T / S ] <br />LCJ HYDROLOGIC BALANCE ................ L Y / NA / N / ®/ Y / B / T / S ] <br />LCJ BACKFILL & GRADING ................ L Y / NA / N / R / V / B / T / S ] <br />LC] EXPLOSIVES ........................ LQY / NA / N / R / V / B / T / S j <br />LC] PROCESSING WASTES ................. L Y/ NA J N J®/ V I B ! T ! S ] <br />LCJ SUPPORT FACILITIES ................ L~/ NA / N / R / V / B / T / S ] <br />L~:] TOP$OIL ........................... L Y / NA / N / ®/ V / B / T / S J <br />LC] GENERAL MINE PLAN COMPLIANCE,,,,,, L 0 / NA / N / R / V / B / T / S 7 <br />LC1 FISH & WILDLIFE ................... L ©/ NA / N / R / V / B / T / S ] <br />LCJ REVEGETATION ...................... L Y / NA / N /~/ V / B / T / S ] <br />LCJ AIR RESOURCE PROTECTION........... L Y / NA / N /®/ V / B / T / S <br />LCJ SLIDES & DAMAGE ................... L~/ NA / N / R / V / B / T / S ] <br />LCJ SUBSIDENCE ........................ L Y/ NA / N / R/ Y / B / T / S J <br />LCJ EXCESS SPOIL & DEVELOPMENT WASTE.. L Y / NA / N /®/ V / B / T / S ] <br />LCJ OFFSITE SUPPORT FACILITIES........ L Y / NA / N / ®/ V / B / T / S ] <br />LCJ RECLAMATION SUCCESS ............... LQ/ NA / N ~/ V / B / T / S ] <br />LCJ SPECIAL CATEGORIES OF MINING...... L Y / NA / N / R / V / B / T / S ] <br />(1) L20 <br />(2) -------------------- Spaces <br />(3) -------------------- Max] <br />- - - - - - - - - - - - - - - - - - - - <br />LC) OTHERS ............................ L Y / NA / N / OR / V / B / T ] <br />(„ P~~_s2~~o~----------- L2D <br />(2) Spaces <br />(3) -------------------- MaxJ <br />- - - - - - - - - - - - - - - - - - - - <br />NOTE: LC] = Required Entry. <br />