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United States Department of the Interior <br /> Office of Surface Mining <br /> Mine Site Evaluation Inspection Report <br /> 2&Sfatas ft dt Number 27. Date of Inspection <br /> Y M M D <br /> — C <br /> 21L Yee No Do mining and reclamation activities on the site comply with the plans in the permit? <br /> ❑ ❑ If rip,provide narrative to support this determination. <br /> 21L Indicate number of complete and partial inspections conducted by the State to date for this annual review period: <br /> 29& m Number of Completes 29b. m Number of Partials <br /> 30.Indicate number of complete and partial Inspections required by the State during this annual review period: <br /> 30a. m 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 /> Te*4)ay Notice No. - Notice of Violation No. Cessation Order No. Violation Codes <br /> A❑ ..................... ❑ ..................... ❑ Authorizations to Operate <br /> 13❑ - -•---------------- ❑ ❑ Sign and Markers <br /> d <br /> C❑ ..................... ❑ ❑ ........................ ackfilll n Grading B nga dG g n <br /> D Hi h g wall Elimination <br /> E ❑ _ ❑ Rllis and Gullies <br /> F❑ ..................... ❑ ..................... ❑ ........................ Improper Fills <br /> G❑ ❑ ❑ Topsoil Handling <br /> H❑ ..................... ❑ ❑ ........................ Sediment Ponds <br /> I ❑ ..............-....... ❑ ❑ Efflu <br /> ent t Limits <br /> ❑ -------- Water---------.... ❑ ........................ <br /> Monitoring <br /> K❑ ❑ ..................... ❑ ........................ Buffer Zones <br /> L❑ ..................... ❑ ❑ Roads <br /> El ...................... <br /> M ❑ ...................... F] ........................ Dams <br /> N❑ ..................... El ................ ❑ Blasts <br /> ng <br /> O El ..................... El ..................... 1-1 ........................ Revegetation <br /> P❑ ..................... ❑ ❑ ........................ Spoil on the Downslope <br /> 0❑ •.................... ❑ ..................... ❑ ........................ Mining Without Permit <br /> R❑ ..................... ❑ ..................... ❑ ........................ Exceeding Permit Limits <br /> S❑ ..................... ❑ ..................... ❑ ........................ Distance Prohibitions <br /> T❑ ..................... ❑ ❑ ........................ Toxic Materials <br /> U❑ -•-• ................ ❑ ❑ Other Violations <br /> 33 �. of Autfrorized Representative(print or type) <br /> O.y-%, � -Z <br /> Signature of Authormed Representative Date 0 <br /> Signatures of ng cial Date <br />