Laserfiche WebLink
Page 2 of 2 Pages <br /> United States Department of the Interior <br /> Office of Surface Mining <br /> Mine Site Evaluation Inspection Report <br /> 21L State Permit Number 27. Date of Inspection <br /> (YYMMDD) <br /> 21L Yes No Do mining and reclamation activities on the site comply with the plans in the permit? <br /> ❑ ❑ If no,provide narrative to support this determination. <br /> 29. Indicate number of complete and partial inspections conducted by the State to date for this annual review period: <br /> 29a. ❑ Number of Completes 29b. ❑ Number of Partials <br /> 30. Indicate number of complete and partial inspections required by the State during this annual review period: <br /> 30L ❑ Number of Completes 30b. ❑ Number of Partials <br /> 31. Has inspection frequency been met? <br /> Yes No Yes No <br /> 31a. ❑ ❑ Completes 31b. ❑ ❑ Partials <br /> 32. FEDERAL ENFORCEMENT INFORMATION. [Enter violation number. Check appropriate box(es)] <br /> Ten-Day Notice No. Notice of Violation No. Cessation Order No. Violation Codes <br /> Authorizations to Operate <br /> Signs and Markers <br /> C❑ ..................... ❑ 1-1Backfilling and Grading <br /> ..................... <br /> D❑ ❑ ❑ Highwall Elimination <br /> ..................... ........................ <br /> E❑ ❑ ❑ Rills and Gullies <br /> ..................... ........................ <br /> F❑ ..................... ❑ ❑ Improper Fills <br /> ................. .... ........................ <br /> G❑ ❑ ❑ Topsoil Handling <br /> ..................... ........................ <br /> H❑ ❑ ❑ Sediment Ponds <br /> ..................... ..................... <br /> I ❑ ❑ ❑ Effluent Limits <br /> J ❑ ❑ ❑ Water Monitoring <br /> Buffer Zones <br /> L❑ .. ❑ ..................... ❑ Roads <br /> M❑ ..................... ❑ ..................... ❑ .... ............... ... .. Dams <br /> N❑ •-------------------- ❑ ............... ...... ❑ ............ .. .. ... ..... Blasting <br /> Reve etation <br /> P❑ ❑ ❑ Spoil on the Downslope <br /> Mining Without Permit <br /> Exceeding Permit Limits <br /> Distance Prohibitions <br /> Toxic Materials <br /> Other Violations <br /> 33. Name of Authorized Representative(print or type) <br /> Signature of Authorized Representative Date <br /> Signature of Reviewing Official Date <br /> Distribution_Original-Field Office,Green- Headquarters, Blue-State's Copy,Yellow- Inspector's Copy, Pink- File Copy I - 163(1/83) <br />