Laserfiche WebLink
Date /0/ ! /, /a <br />AVS Annual Review <br />Inspection Worksheet <br />Mine Name/Permit Number 19 ?/ 41t <br />Inspector Signature <br />c) MSHA ID b' <br />If No, what is in conflict? <br />Based on your ON -SITE Obse ''n, please answer the following: <br />1) Mine ID sign l <br />a) Permittee , �� 7 a- * r <br />b) Operator _ Uv / l i <br />2) Direct inquiry (of persons on the site) <br />a) Permittee 44 <br />,l/J / V <br />b) Operator / [p[L (N <br />c MSHA ID 0 0/S7 <br />7 <br />3) Is ownership /control information for permittee operator noted in field consistent with <br />what is listed in the permit application? Yes No <br />(not required to be on sign) <br />DRMS is required to verify this information as specified in the AVS MOU if the permitting action was <br />approved subsequently to the MOU (renewal, transfers and revisions). Annually as long as coal <br />extraction from the site has not been completed, DRMS must determine whether officer /controller <br />information is complete and accurate in AVS. In making the determination of complete and accurate <br />information, on -site observations and direct inquiry of persons on the site is necessary. The information <br />on this form will be verified with AML, MSHA, and EIA information in AVS. Please return the form to <br />Mary Rodriguez to be verified in the AVS. <br />