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~uu~ ~ ~ w~: dli ll;V <br />UfVlSION OF MINED LANU RECLAMAf10N <br />COAL PROGRAM <br />Clvll Penalty Worksheet <br />I. identification <br />Permlttee/Operator IWI~ t':NE~ <br />Permit No. (~ n^ 3 -~'j 8 <br />NOV/CO No. C' 1 Z U I5 <br />Date of Issuance ~/Ils•l`!z <br />Type of Violation <br />Administrative <br />Performance Std. r'~ <br />Permlt Condition Y <br />II. Action <br />Penalty Rssessed Yes No <br />Proposed Amount .YS~~=~~~~'~ <br />Source of Information or assessment <br />Operator/Permlttee <br />Division ~~ <br />III. Mandatory Penalties <br />Cessation Order <br />Fal lure to Abate 5150.00 - f5,000.001day X days <br />Mlning Without a Permlt <br />IV. Penalty Calculation Criteria - Rule 5.04.6 <br />_ Cateaorv Comments <br />A. History <br />O NOV's past 12 months x (50.00 <br />O CO's past I2 months x f250.00 <br />B. Seriousness <br />Severe 51,500 51,750 <br />Significant 11,000 (1,250 <br />Low/Moderate f250 5500 f750 <br />Insignlfitant f0 <br />Administrative f <br />C. Fault <br />Intentional f1,000 51,250 (1,500 <br />Negligence 5250 ;500 f150 <br />Unavoidable 0 <br />D. Number of Davs Penalty Assessed <br />E. Good Faith (may not exceed 51,250.00) <br />Credit - Ex traord lnary Effort n /~ <br />Credit - Rapid Compliance ~V <br />/l h rre wrt, t,,, ~,fT „1 c• ~(om~r; <br />[/rl -S//l fP /G~c!/7 nqa bV SS /n.Pn v";r <br />c,q N/yl/~/lonr c~a H,oyo t',tls /r,/ <br />jrn/re,,ICIYP59t.n/c ~~~/, ~ui rr te~ri F• n,r <br />few LJP Of ~I dr>d~M~ S (31m PVPoIZ` <br />~or wNrrl l-l~r•y wrrr rry ~u~'-~/ <br />//~ ~ r <br />-I be r~.e lq ~~,• y+, os h.r//.y pp ~- o-. <br />~..t nrC•.(laim.r, O/:c/~n~ ['n r3 ~'~ryiry <br />f7/~ty~rrl artarc~il+c ~~ dr~,cn <br />i <br />Plnns. <br />Good tali! a n,> o~:l,l«// l/ <br />JlktP/ OGq~P/Y Pa~ IJJSI n /t p~'Pal . <br />(~rtrllic~rl~ ~D L~7/P- <br />~> TOTAL ~ %~~~'~ • ~ ~ <br />2ar-r /~ /i`~-~ i~ Assessment Officer <br />Slgnatug ' <br />cY rr v / • ~oN~f~n Date ~"~ / j - 9-Z <br />Name Printed <br />4672E <br />