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I Oncument 1127E ~ Revised 10/:°: AMMADE 01 G?AL NO IICE fi= VIOLA LION COUiNG FiiRM ' ___qq_________________________________ CC7 VIOLAT G]N NUM6ER........... C_ - J_ 3 - d ~' n c• r CC1 MINE UR EXPLOkATiON [U 0... ` - ~_ ~ - V _~ v) - __ CATEGORY OF VIOLATION ..... V_ CC7 INSPECTION DATE............ ~ ~ / ~ 7 / 9 :3 VIULAT ION TOPICS VIOLAjION_T OP ICS :C] PflIMARY TOPIC..... ['~ R SECONDARY TOPIC.... __ __ TERTIARY TOPIC.... __ __ (CL-IE~ AD=Administra}ive, RD=Roads, AP=Air Resource Protection, RS~=Reclamation Success, AR=Availability of Records, RV=Revegetation, BG=BackFilliny 8 6r ading SB~=Subsidence, ' CR=Contemporaneous Reclamatio n, SC=Sediment Control', ES=Excess Spoil 8 Uev. Waste, SU=S9ides 8 Other Damage, EX=Explosives, SF'=Support Facilities On-si}e, FW=Fish 8 Wildlife, SM=Signs 8 Markers,, HB=Hydrologic Balance, SN=Suppart Facs, No} On-si}e, HM=Hydrologic Monitoriny, SP=Special Categories of Mining, MP=Gen. Compliance With Plan, TS=Topsoil, PW=Processing Waste, OR=Other) '! DATE ISSUED ................... O 7 / I ~ / cJ 3 ' DATE OF UN-SITE HEARING....... __ __ / __ __ / i VIOLATION DESCRIPTION• ______________________ x'_911-~ ~e __L s1 __!-1~ty~ __J N_ F~~~n <iT_~_ ~7 fJ -- f~ T __ it 1 N _~ __ 5 ~_ 7 ~ -- -- -- -- -- -- -- -- -- -- f50 Spaces) ABATEMENT DUE DATES ____________________ SEPARATE ABATEMENT DESCRIPTIONS ________________________________ C ~i / ol?'I / `~ 3 ~!? R V D ~ [ ;~ O 2lYlf1 J' 1_ ~ N ~ ~ [~l J_ _ -- - _i _ _ _ -- - -- ^'- ~ -- S ~- T c -- -- -- -- -- -- -- -- -- --~ -- -- -- -- -- -- -- -- -- - - -- -- - -- - -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- - - -- - -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- . -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 150 -- -- -- Spaces) :eOTE_^ (17 CC7 = Required entry Far all Notice of Violation records. i ~~~PERATOR_NOTE• Enter "NATURE OF VIOLATION" narrative on opposite side into "NARkATIVE EDI7"' screen. - ~.