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Date /0 <br />Inspector Signature <br />If No, what is in conflict? <br />AVS Annual Review <br />Inspection Worksheet <br />Mine Name/Permit Number /--W,4 54 ��' , /,„/r- <br />Based on your ON- ITE Obser ation, please answer the following: <br />1) Mine ID sign <br />a) Permittee 'EAd�� q ',- ���fi —, //, , L- e <br />b) Operator / /7, �.��C— (.�f�" /� .r��/� G z <br />c) <br />2) Direct Direct inquiry (of persons on the site) <br />a) Permittee /' / /A/9 G L <br />b) Operator <br />c) <br />(not required to be on sign) <br />3) Is ownership /control information for permittee and operator noted in field consistent with <br />what is listed in the permit application? Yes X No <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 />