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'., I ~\ I L UI ~.UUJIiI\L~V <br />DIVISION OF MINEU LAND RECLAMATION <br />,~ COAL PROGRAM <br />" Civil Penalty Worksheet <br />.' <br />I. Identification II. Action <br />PermitteelOperator~v „\, ,1 ,\ \1~.;ti,,,,~~„rPenalty Assessed Yes No <br />s< (- <br />Permit No. ~_ '~-,~ c_~~-i~', Proposed Amount ~.2~0 <br />NOV/CO No. (~ '~\1 \~~i'`l Source of information or assessment <br />Date of Issuance ~ \~.~ ~.1~\\ Operator/Permittee <br />Type of Violation ~ Division <br />Administrative <br />Performance Std. ~_ <br />Permit Condition <br />III. Mandatory Penalties <br />Cessation Order <br />Failure to Abate $750.00 - $5,000.00/day X days <br />Mining Without a Permit <br />IV. Penalty Calculation Criteria - Rule 5.04.6 <br />Cateaorv Comments <br />A. H15tory <br />(~ NOV's past 12 months x $50.00 <br />~~ CO's past 12 months x $250.00 S'~ ,~1fai~~°~ ~~af~ <br />B. Seriousness <br />Severe $1,500 $1,750 <br />Significant $1,000 $1,250 <br />Low/Moderate $250 $500 $150 <br />Insignificant $0 <br />Administrative $ <br />C. Fault <br />Intentional $1,000 $1,250 $1,500 <br />Negligence $500 $750 <br />Unavoidable $0 <br />D. Number of Davs Penalty Assessed ~_ <br />E. Good Faith (may not exceed $1,250.00) <br />Credit - Extraordinary Effort <br />_ Credit - Rapid Compliance <br />//~~ TOTAL ~-Z~'~~ `'=' <br />~~.~.,i~Gf lxc ~i~ Assessment Officer <br />~ gnat e pp .y- <br />Ld/'~Y ~~ ll~~ ll~~] Date c~f~.2~~~/~ <br />Name inted <br />4672E <br />