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s STIPULATION AND COMMITMENT CODING FORM <br />,~ COAL PERMIT COMPLIANCE REQUIREMENT INITIAL ENTRY FORM <br /> <br />PERMIT N0. C - S1 ~ - 0 <br />PERMIT COMPLIANCE TYPE CODE <br />STIPULATION, COMMITMENT, ANNUAL <br />FEE OR REPORT SUBMITTAL NO. <br />STATUS OF COMPLIANCE <br />DATE OF ORIGINATION <br />SOURCE OF ORIGINATION <br />SUBMITTAL CATEGORY <br />~', <br />DUE DATE FOR PERIODIC SUBMITTALS <br />FREQUENCY OF SUBMITTALS <br />~~ <br />31~~ <br />S _~ AB=Drill Hole Abandonment Report, CI-Certification/Inspection, CM=Commitment, <br />MR~Monitoring Report, ST-Stipulation. TR=Technical Report <br />a 8 (o1-ssl <br />C~ AC=Active, FU~Future, FG-Forgiven, CW=Complied With, TR=Terminated <br />a 3/a ~/~~ <br />1 S PR..Permit Approval, PS~Performance Standard in Regulations, RV=Revision Approval <br />S ~ AM~AOC Monitoring Report, BR-Blasting, CI=Certification/Inspection, GT>Geotechnical, <br />GW~Groundwater, HY~General Hydrology, SO~Soils, SU=Subsidence, SW=Surface <br />Water, VE~Vagetatlon Report, WL-Wildlife, OR~Other <br />Q ,1 (~ 0 / ~ ~ (Roquired, unless "Status of Compliance' =Future) <br />Ol Annually, 02~Seml-Annually,. 04. Quarterly, 06=Bi-Monthly, 12=Monthly, 99=One- <br />Tlme Submittal <br />COMPLIANCE REQUIREMENT DESCRIPTION • BRIEF OUTLINE( (50 Spaces Maximum) <br />""•"•""'•"'•"•'•"•"' ENTER DESCRIPTIVE NARRATIVE PARAGRAPH ON NEXT PAGE •••"••'••••••••'••"'•"•••• <br />NOTE: All entries are required, with the exception of 'Compliance Requirement Description.' <br />The purpose of this file Is to allow the Spadallst t0 enter those Compliance Aequirements placed upon a <br />permit, about which that Spedalist desires to be tickled prior to compliance due date. <br />A separate coding form must ba completed for each compliance requirement. <br />