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III IIIIIIIIIIIIIIII ~ ~' ? <br />~_ <br />""~~''9Y.Rl'. <br />'I T <br />~ <br />' - <br /> <br />~ y..:(uY4.. <br />s` . s x•,rn. <br />;I jni J •r3'~~ <br />i ~ "~ ,ftr>F ~rc.4•c'g y. { <br />.- <br />i-'` ~'1 <br />2ik <br />u <br />iR.-} <br />~ <br />` ~~~ <br />eri of thei lnt <br />• •- ~'-- rti d p8F erfgg a 44rr"r ftic e Use dn.[ <br />- <br />" ~ ~~- <br />atiorrlnspectfork.Repor <br />.. Min <br /> <br /> <br />_ ~ y /f <br />l ( <br />2 N <br />f P <br />'?- / Y O r <br />. <br />''4 ~°'~ <br />~ ~O <br />J ~ <br />MSHA N <br />b <br />~ ~ '~ ' ~ <br />9 10. Date of (nspectbn <br />Y Y M M~ O D <br />artn <br />sms o <br />aw , <br />(. <br />@ <br />~ <br />' um <br />er <br />. ( <br />) <br />` <br />d~ ~ ~11~ a I ~ ~O~ -~ ~ ~ -b'~ .' ~ L <br />8V ~~ <br />3. Street Atldraaa 11. State Pormlt Numbu <br /> x - a - _ 8 r <br />.1. City 5. State 1Z. Name of Mins ' <br /> <br /> o ~. ~ m w r r <br />BiZIp Cods 7. Area Code 8. Telephone Number 73. County C 16. Slate Cotla 15: Strata tB. State Area Ollica <br />06 ~ -~I ! 6 7 ~ m ~ . <br />17. OSM FIelO iB. OSM Area 79. OSM 20. Type of Inspection 2f. Join! InspeGlon - ~ 22. Inspxlor's ID ~' <br />OHlce No. Olllcs No. Sample No. <br />~ ~ _ ~ <br />(Code) Yes I <br />Nno I <br />~ ~ No. <br />0 ^ ~ <br />I <br />LJ <br />23. Status. 26. type of Activity (check apphcaDle boxes). <br />A ~ Type of Permit <br />A ~ Steep Slope <br />E ^ Anlhncite <br />B ® Mlne Status (Code) <br />0 ~ Mountain Top Removal <br />F ~ Federal Lands <br />C © Type of Facility (Cove) <br />C ~ Prime Fzrmlantla <br />G ~ Intllan Lantls <br />D /~~ ~ ~ • Number of Permitted Acres <br />D ~ Alluvial Valley Floors <br />H ~ Other <br />E (^, .; ^ • Number o! Olaturbed Acres <br />25. Performance Srantlards (Codes! <br />Ingrur:rbnc Indicate compliance code. For any stantlartl marketl 2 or 3 prov~tle narrative to support This determination. <br />Standards Thel Llmlt the Elfecls to the Permll Area Standards That Assure Reclamation Qualdy and Timeliness <br />A ~ Dlstanee Prohiblflona M ~ Topsoil Hantllinp <br />8 a Mlnlnq Wlthln Permit Sountleriea N ~ Backfiilinq antl Grading <br />C ~ Slgna antl Markers O ~ Following Reclamation Scnetl~ila <br />D ~ Setliment Control Measures P ~ Ravegelation Requirements <br />E ~ Dealgn antl Certlllcatlon Requirements- O ~ Disposal of Exceaa Spoil <br />Setllmsnt Control <br />R ~ Hantlling of Acitl or Toxic Materials <br />F ~ EHlusnt Llmlta <br />S ~ Hlghwall Elimination <br />G ~ Surface Water Monitoring <br />T ~ DownsloDe Spoil Disposal Fla., ~._. <br />'^-r O. rti'~ <br />H ~ Ground Water Monitoring Sf~ <br />Poal Minin <br />Land Use <br />U ~ ~ r J <br />7 ay <br />1 ~'Bleeting Procedures g <br />~ <br /> V ~ Cessation of Operations: Temporary. <br />J ~ HaullACCSSe Roetl Design antl Maintenance <br /> <br />L <br />K >^' Rafuas Impoundmenla ~~ ~-~ ~ - r~^ <br />W . ~ Other <br />L ~ Other. SDepify ~~ <br />-. Dbhlbutlon: Orlplnal - Field Olflu, Green - Heatlquarta lire ~ State's Co ,Yellow-- InaDector'a Copy, Pink -File Copy. <br />.- \ <br />Sv' _ <br />.>., <br />s,~f <br />-~-~ <br />IE-10.711/83) '~ I <br />-~1 <br />,. <br />