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United States Department of the Interior <br /> Office of Surface Mining <br /> Mine Site Evaluation Inspection Report <br /> 26.State Permit Number 27. Date of Inspection <br /> (YYMMDD) <br /> 26. Yes N Do mining and reclamation activities on the site comply with the plans in the permit? 1r <br /> O If no, provide narrative to support this determination. S o J S S <br /> 29. Indicate number of complete and partial inspections conducted by the State to date for this annual review period: <br /> 2ga. E�] 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 /> 30a. 61Z Number of Completes 30b. ® Number of Partials <br /> 31. Has inspection frequency been met? <br /> Yes No Yes No <br /> 31a. (I ❑ 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 /> A❑ ❑ Authorizations to Operate <br /> B❑ .................. ❑ ..................... ❑ ........................ Signs and Markers <br /> C❑ ❑ ❑ Backfilling and Grading <br /> ..................... ........................ <br /> D❑ ❑ ❑ Highwall Elimination <br /> E❑ ..................... ❑ ..................... ❑ ........................ Rills and Gullies <br /> F❑ .... ❑ ..................... ❑ ........................ Improper Fills <br /> G❑ ..................... ❑ ..................... ❑ ........................ Topsoil Handling <br /> H❑ ..................... ❑ ..................... ❑ ........................ Sediment Ponds <br /> 1 ❑ ❑ ❑ Effluent Limits <br /> J ❑ ❑ ❑ Water Monitoring <br /> t{❑ ❑ ❑ Buffer Zones <br /> L❑ -----•-------•------• ❑ --------------------- ❑ ........................ Roads <br /> M❑ - - 1-1 ..................... ❑ Dams <br /> ........................ <br /> N n u ------------------•. ❑ ❑ Blasting <br /> O❑ ❑ ❑ Revegetation <br /> P❑ _____________________ ❑ ❑ Spoil on the Downslope <br /> ............... ...... ........................ <br /> Q❑ ❑ ❑ ........................ Mining Without Permit <br /> R❑ ❑ ❑ Exceeding Permit Limits <br /> S❑ ❑ ❑ Distance Prohibitions <br /> T❑ ❑ ❑ Toxic Materials <br /> ........ . .. <br /> ll YN !4t� OtS iPo.S.... ❑ ............. Other Violations <br /> 33. Name of Authorized�ese_ntative(print or type) 34. Administrative Information <br /> r��"tt�l 'r ► 6, a Permit Review (Hours) <br /> Sig ature o Authorized Re ese tative D to <br /> gg' b . Travel Time (Hours) <br /> Signet view' g Of jDate c '+771.151 inspection Time (Hours) <br /> d �f/ --� Report Writing Time (Hours) <br /> D-Oribution. Original Field Othee, Green - Headquarters. Blue State's Copy. Yellow - Insne'ct�or's-'CCoom Pink - File Cony IF - 163 1119131 <br />