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RECLAMATION VISUAL INSPECTION FORM <br />IN <br />Date:. JG /a 1 p Site /Map #: 5C-R633 Inspected By: <br />Location: !S 75- --- 1-/6, 3 <br />Year Reclaimed: Seed Mix: <br />Dominant Vegetation: (include grasses, fortis, shrubs, warm season grasses, etc. by spp.) <br />Weed Problems: <br />General Health: <br />Erosion /Site Stabilization: /a!l" <br />Notes: <br />Recommendations: <br />SAE Designation: Drill Hole _ Typical Flat _ Well Vegetated <br />Soil Pile — Typical _ Large _ Well Vegetated <br />