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Permit No: <br />REQUEST FOR AVS COMPLIANCE CHECKS <br />C t9g t -ro(c) <br />Application Type & #: <br />Applicant: ?r MSHA Id No.: <br />RN7?- <br />1St Check: Adequacy of application (within 30 days of completeness) 07-\ wa /d- f- <br />Attach a current list of the owners and controllers for the applicant and the operators, as required <br />by Rule 2.03.4, Identification of Interests. If applicable, a list of permits held by the applicant in <br />other states, by numbers and state codes. <br />Date AVS: g ?1 0 Date OSM: 0 <br />AVS Evaluation: k)W\bn OSM Evaluation: Uiptaho? r ?NaT <br />a '-o - <br />DMG Recommendation: SSUP whs sfu?Fed ??°?`'? <br />Note: Once you get the new information back from the operator on any AVS questions or concerns, <br />please give to AVS person to make sure the concerns have been fixed and AVS can be updated. <br />2nd Check: Proposed Decision of application (3-5 days prior) <br />Date AVS: -? ,,25-Ug Date OSM: 7-1 ?- <br />AVS Evaluation: Sc-6 V&C )bns <br />OSM Evaluation: "?Jed tbln-?Itws <br />DMG Recommendation: _ <br />3rd Check: Issuance of application (3-5 days prior) <br />Date AVS: 0 Date O M: <br />AVS Evaluation: - ' 1d <br />OSM Evaluation: <br />DMG Recommendation: <br />Sl LQ, <br />Final Check: After Issue/Decision timeframes are over <br />Date of Issue/Decision: <br />Permit Expiration: <br />Permitted Acres: <br />_ p A?S A-6o V-,5 ()V? <br />P v'--e C? kQ-CAS \ (v <br /> <br />***AVS checks are required for new permit, permit revision, permit renewal, and permit transfer/succession of <br />operator. AVS checks are also for SOAP applications and state contracts. <br />MAcoal\share\forms\Request for AVS Compliance Checks.doc <br /> <br />-Tl-aflp r dv?S No 3- (0) <br />J