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<br />REQUEST FOR AVS COMPLIANCE CHECKS <br />Permit No: C- 17 $ ( -0 3--3 Application Type & #: RAI -O <br />Applicant: ,Q E A R, Cb A j- CotrPA Aj V MSHA Id No.: 0 S - 0 3-7 S -7 <br />1St Check: Adequacy of application (within 30 days of completeness) <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: D Date OSM: <br />AVS Evaluation: t (i os <br />OSM Evaluation: , v C-Th Y? <br />DMG Recommendation: TsSuPl <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 />2"d Check: Proposed Decision of application (3-5 days prior) <br />Date AVS: LG I 19 D to OSM: <br />AVS Evaluation: v V\ <br />OSM Evaluation: <br />DMG Recommendation: ?Q <br />3rd Check: Issuance of application (3-5 days prior) <br />Date AVS: 4 ate O $M: <br />AVS Evaluation: v 1 0-fib V2 <br />OSM Evaluation: <br />DMG Recommendation: L(,P <br />Final Check: After Issue/Decision timeframes are over <br />Date of Issue/Decision: <br />Permit Expiration: <br />Permitted Acres: <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