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<br />Sea Continuation Form IMSHA Form 7000;351 ~J <br />9. Violation A. Health B. Section _ C. Frart/Section of <br />n?hetMy ~ of Act Title 30 CFR ~ ~ y~' ~ p O <br />Section II-Inspector i Evaluation <br />10. Gravity: <br />A. Injury or Illness (has) lisl: No Likelihood^ Unlikely ^ Reasonably Likely Highly Likely^ Occurred ^ <br />B. Injury or Illness could rea- <br />sonably be expelled to be: <br />No Last Workdays^ <br />Lost Workdays or Restricted Duty ^ <br />Permanently Disabling^ Fatal <br />C. Significant and Substantial (See Re~.ersel: Ves, ~ No ^ D. Number of Persons Affected O <br />17. Negligence (check one) <br />A. None ^ B. Low ^ C. Moderate ~ D. High ^ E. Reckless Disregard ^ <br />12. Type of Action 13. Type of Issuance (check one) <br />G - - ' - - Citation ® Order ^ Safeguard ^ <br />14. Initial Attion E. Citation/ F. Dated Mo Da Yr <br />D. Written Order <br />A, Citation^ B. Order^ C. Safeguard ^ Notice ^ Number <br />15. Area or Equipment <br />A Date ~ I,/ ~I p Clr., B. Time 124 Hr. Clock) ~~ ~ I~ <br />Mine'Citation/Order U.& Department of bor S~* <br />• Mine Safety and Healt~ministrati -YE[3`~ <br />R2f5 GC:,.:: pct <br />(yG~CiL ~ E~ GL .G,escclN /I..~~ acr~r v v <br />17. Action to Terminate / <br />tit /M i//A ~~ <br />I <br />