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zr- <br /> MC <br /> MAY 2 9 1986 Page 1 of 2 Pages <br /> United States Department of the lqw -�Fcir Office Use Only <br /> Office of Surface Mining 1 a 1 b 1 c <br /> Mine Site Evaluation Inspection Report LT IT <br /> y Y M M Batch Report <br /> 10 Date of Inspection <br /> 2. Name of Permittee 9 MSHA Number (Y Y M M D D) <br /> I I H-TT � � [-TTT�_1 <br /> 3. Street Address 11 Stat- Permit Number <br /> 71 <br /> FTTI-q= H I, E-LI -1-1- <br /> 4.City 5 State 12 Namp of Mine[Efflfflffl 7 1 ` 717 " -LI-] <br /> 1 1 <br /> 6.Zip Code 7.Area Code 8.Telephone Number 13 County Code 14 State Code 15 Strata 16 State A ea Office <br /> LTT-RT 11E E-L-I'll F T LLI L <br /> 17.OSM Field 18. OSM Area 19. OSM 20-Type of Inspectior 21 Joint Inspection 22 Inspectors ID <br /> Office No. Office No. Sample No (Code) Yes No No <br /> 23.Status 24 lype of Activity(0,eck applicable coxes) <br /> A Type of Permit f—-I <br /> B Mine Status(C6de) Steep Slope E Anthracite <br /> B I Mountain Fop Ffemo,ai F Federal Lands <br /> C Type of Facility(Code) C Prime Farmlands G .Ll Indian Lands <br /> D F7 I I I I I I Number of Permitted Acres D Alluv,al Valley Floors H Other <br /> E 17 • Number of Disturbed Acres <br /> 25 Performance S*andar& (Codes) <br /> Instructions: Indicate compliance code For any standard marked 2 or 3 provide narrative to support this determination <br /> Standards That Limit the Effects to the Permit Area Standards That Assure Reclamakon 0-,jality and Timelmess <br /> A Distance Prohibitions M Topsoil Handling <br /> B Mining Within Permit Boundaries N Backfi;llng and Grading <br /> C F] Signs and Markers 0 L J Following Reclaniat,or, Sched-de <br /> D F] Sediment Control Measures P Reveyetation Requirements <br /> E F-1 Design and Certification Requirements— Q Ll Disposal of Excess Spoil <br /> Sediment Control <br /> F F-1 Effluent Limits R Handling of Acid or Toxic Materials <br /> S Highwall Elimination <br /> Surface Water Monitoring <br /> G F1 Ground Water Monitoring T Downslope Spoil Disposal <br /> H F-1 U F-1 Post Mining Land Use <br /> I Blasting Procedures V E] Cessation of Operations Temporary <br /> i Haul/Access Road Design and Maintenance W [:] Other <br /> K Refuse Impoundments <br /> L Other: Specify <br /> Distribution: Original-Field Office,Green -Headquarter Blue-State's Copy, ellow- Inspector's Copy. Pink- File Copy I E- 163(1/83) <br />