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For the Following Entries, Circle the Appropriate Choice: <br />Y = Inspected and Found in Compliance <br />N = Not Inspected <br />R = Inspected and Comments Noted <br />V = Inspected and Violations (NOV) or Cessation Order (CO) Issued <br />NA = Inspection Topic Not Applicable <br />GENERAL INSPECTION TOPICS: <br />I <br />[C] <br />AVAILABILITY OF RECORDS ........................ ............................... <br />Y / <br />N <br />/® / V <br />/ NA <br />[C] <br />SIGNS AND MARKERS .................................... ............................... <br />(D/ <br />N <br />/ R / <br />V <br />/ NA <br />[C] <br />ROADS ................................................................ ............................... <br />Y / <br />N <br />/ OR / <br />V <br />/ NA <br />[C] <br />HYDROLOGIC BALANCE ............................... ............................... <br />Y / <br />N <br />/ OR / <br />V <br />/ NA <br />[C] <br />BACKFILL & GRADING ................................... ............................... <br />Y / <br />N <br />/ O / <br />V <br />/ NA <br />[C] <br />EXPLOSIVES ...................................................... ............................... <br />Y / <br />N <br />/ R / <br />V <br />/ <br />[C] <br />PROCESSING WASTE ....................................... ............................... <br />Y / <br />N <br />/ R / <br />V <br />/ & <br />[C] <br />SUPPORT FACILITIES ...................................... ............................... <br />OY / <br />N <br />/ R / <br />V <br />/ NA <br />[C] <br />TOPSOIL ............................................................. ............................... <br />©/ <br />N <br />/ R / <br />V <br />/ NA <br />[C] <br />GENERAL MINE PLAN COMPLIANCE .......... ............................... <br />YO / <br />N <br />/ R / <br />V <br />/ NA <br />[C] <br />FISH & WILDLIFE ............................................. .:............................. <br />OY / <br />N <br />/ R / <br />V <br />/ NA <br />[C] <br />REVEGETATION ............................................... ............................... <br />Y / <br />N <br />/ RO / <br />V <br />/ NA <br />[C] <br />AIR RESOURCE PROTECTION ....................... ............................... <br />G/ <br />N <br />/ R / <br />V <br />/ NA <br />[C] <br />SLIDES & DAMAGE ......................................... ............................... <br />OY / <br />N <br />/ R / <br />V <br />/ NA <br />[C] <br />SUBSIDENCE ..................................................... ............................... <br />Y / <br />N <br />/ R / <br />V <br />/ <br />I <br />[C] <br />EXCESS SPOIL & DEVELOPMENT WASTE .. ............................... <br />Y / <br />N <br />/ R / <br />V <br />/ <br />[C] <br />OFFSITE SUPPORT FACILITIES .............................. <br />Y / <br />N <br />/ R / <br />V <br />/ N� <br />[C] <br />RECLAMATION SUCCESS .............................. ............................... <br />Y / <br />N <br />/ RO / <br />V <br />/ NA <br />[C]I <br />SPECIAL CATEGORIES OF MINING .............. ............................... <br />Y / <br />N <br />/ R / <br />V <br />(2) ----- - - - - -- <br />(3) ------------- <br />- <br />- <br />- <br />- <br />-- <br />OTHERS .............................................................. ............................... Y / N / R / V / �L[ 1B <br />(2) -------------------- <br />(3) —----------- - - - - -- <br />Page —2— of —6— Pages, (date) 11 /12/2009 (initials) ft <br />