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~nlted States Department of the I~rior <br />j ~ Office of Surface Mining <br /> Mine Site Evaluation Inspection Report <br />ffi State panrttlt Ntenbsr 27. Date of Inspection <br /> (YYMMDD) <br /> <br />28 Yes Do mining and reclamation activities on the site comply with the plans in the perrnll? <br />O It no, roNde namatlve to su ort this tletermmatlOn. <br />29. Indlnte number of complete and partial inspections conducted by the State to tlate for this annual review periotl: <br />29a ~ Number of Completes 29b. ~ Number of Partials <br />30. Indicate number of complete and partial Inspections required by the State tluring this annual review periotl: <br />3tla m Number of Completes 30b. m Number of Partials <br />31. Has lrmpaetien hequertcy been met? <br />Yes No Yes No <br />31a © ^ Completes 31 b. ^ ~/ Partials <br />32 FEDERAL FJiFORCEMEhfT INFORMATION. IEnter violation number. Check appropriate boxJes)J <br />Ter-Dey No11oe No. Notice of Vi olation No. Cessation Ortler No. Violation Cotles <br />"~ "' 1 -~^ - - - - - - <br />A ^ <br />..................... ^ <br />...... ^ Authorizations to Operate <br />............... <br />.B ^ ^ ^ ........................ Signs and Markers <br />C^ ^ ^ Backflllinp and Gretling <br />~ ^ ..................... ^ ...... ............... ^ ........ .. .............. Hlghwall Ellminatlon <br />.... <br />.... <br />E ^ ^ ...... ............. .. ^ .......... .. ............ Rills and Gullies <br />............ <br />. <br />F ^ ..................... ^ ...... ............. .. ^ ........................ Improper Fills <br />_.._••.••.•......_.. <br />G ^ ^ ^ ToPSOII Hantlling <br />_ <br />1 .~~ ! ^ ^ ......••••.,••••••..•.,. Sediment Ponds <br />I ^ <br />__••__...... ...•.. ^ ^ ENluent Llmlts <br />__.. <br />.,1 ^ ^ ^ .................... .. .. Water Monitoring <br />1( ^ ^ ^ ........................ Buffer Zones <br />. ~ ^ ...............•--... . ^ ...... ............... ^ ........................ Roads <br />M ^ ^ ...... .............:. ^ .. ... .................... Dams <br />. ..................... <br />^ ..................... <br />N ^ -..... ......... .. .... ^ ........................ Blasting <br />. <br />O ^ ^ ^ ........................ Revegetation <br />p ^ ^ ^ Spoil on the Downslope <br />p ^ ••._••._..••..•.•_•.. ^ ^ Mining Without Permit <br />R ^ ..................... ^ ...... ............... ^ ...... .. ................ Exceeding PennH Llmlts <br />. <br />S ^ ^ <br />...... ^ Distance Prohibitions <br />............... ........................ <br />•..•.._.._•-...•. •. _ <br />T ^ ^ ^ ...................... .. Toxic Materials <br />- U ~ ^ ~ Other Violations <br />~--33 Name of Aulhor®d.Reprasentative (print or.rype) <br /> <br />Siynttrrre of Author~ad Representative Date <br />~~ oF' ~ G 141f` O¢ D <br />Siprrature of Beoievring OHiciel ~ r Date ~ (,t O <br />U b~ <br />O/ O <br />~ -' <br /> <br />Distritarlion: Oripinel ~ Field Olfice, Green ~ Headpuanars, Blue ~ State's COPY. Yellow ~ insoacior's Coov. Pink - Fiie Coov IE ~ 167 11/El'+1 <br />