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MINED LAND RECLAMATION <br />Application Worksheet/Checklist <br />111 Special Operation Operator: ~l/I??~P~ ~~ <br />Mine Name: ~ -~ ~ 07 <br />Mine ID.: ~?-/~3 mittal Date: /i a?3 Q <br />ITEMS 7 8 9 10 11 12 <br />COMPLETED <br />~ ~ ~ ~ <br />MAPS and EXHIBITS ADEQUACY COMMENTS <br />EXHIBIT A - Legal Description & Location Map / <br />EXHIBIT B - Site Description <br />a. Vegetation & Soils ~ <br />b. Critical structures within 200 feet and offslte damage <br />c. Water Resources and Wildlife Statement (if provided) <br />EXHIBIT C - Mlning Plan <br />EXHIBIT D - Reclamation Plan <br />a. Plan / <br />Application Form <br />