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For the Folly.ring Entries, Circle The Appropriate Choice: = nspec a ari oun in Comp lance, NA = Inspection Topic not applicable, N Nit Inspected, R =Inspected and Comments noted, Y =Inspected ana Violations (NOV) or Cessation Order (CO) issues, B = Inspected and both Comments noted 8 Violations or Cessation Order issued, T 10 Day Notice Issued by OSM Oversight Personnel, 5 =Sample taken and sent to the lab from analysis - describe type ana location of sample taken under comment section. GENERAL INSPECTION TOPICS: CORDS........... L Y / NA / N /~/ V/ B / T / S LCJ SIGNS AND MARKERS ................. L Y / NA / N /~' V / B / T / S LCJ ROADS ............................. L Y / NA / N / (~/ V / B / T / S J LCJ HYDROLOGIC BALANCE ................ L Y / NA / N /®/ V / B / T / S LCJ BACKFILL & GRADING ................ L Y / R(~A / N / R / V / B / T / S LCJ EXPLOSIVES ........................ L ©/ NA / N / R / V / B / T / S J LC] PROCESSING WASTES ................. L Y / NA / N / ®/ V / B / T / S j LCj SUPPORT FACILITIES ................ L Y / NA / N / ®/ V / B / T / S L~] TOPSOIL ........................... L Y/ NA / N /®/ V / B / T / S J LC1 GENERAL MINE PLAN COMPLIANCE...... Lam/ NA / N / R / V / B / T / S J lCJ FISH d WILDLIFE ................... LQr7/ NA / N / R / V / B / T / S J LCJ REVEGETATION ...................... L Q~/ NA / N / R / V / B / T / S J LC] AIR RESOURCE PROTECTION........... L Y / / N /®/ Y / B / T / S J LCJ SLIDES d DAMAGE ................... L / N / R/ Y / B / T / S 7 LC1 SUBSIDENCE ........................ LQ' NA / N / R / V / B / T 1 S J LCJ EXCESS SPOIL d DEVELOPMENT NASTE.. L Y / ®/ N / R / V / e / T / S ] LCJ OFFSITE SUPPORT FACILITIES........ L Y/®/ N / R / Y / B / T / S J LCJ RECLAMATION SUCCESS ............... L®/ NA / N / R / V / B / T / S J LCJ SPECIAL CATEGORIES OF MINING...... L Y / QA / N / R / V / B / T / S J ll) ------------------- L20 (2) - Spaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - LCJ OTHERS ............................ L Y/ NA / N~ V/ B/ T J (2) Spaces (3) -------------------- Max] - - - - - - - - - - - - - - - - - - - - NOTE: LCJ = Required Entry.