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RECLAMATION VISUAL INSPECTION FORM <br />Date: 1 nl Site/Map #: Z c. — ; Inspected By: <br />5�'c <br />Location: L La5�— 3 <br />Year Reclaimed: Seed Mix: <br />Dominant Vegetation: (include grasses, fortis, shrubs, warm season grasses, etc. by spp.) <br />I zleol <br />Weed Problems: <br />General Health: <br />Erosion/Site Stabilization: <br />Notes: <br />Recommendations: <br />SAE Designation: Drill Hole _ Typical _ Flat _ Well Vegetated <br />Soil Pile _ Typical _ Large _ Well Vegetated <br />