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1. Permittee/Person <br />1CA %I HYING, LLC <br />2. 1 4 ddress <br />I P.O.'BOX 98 <br />I <br />3. City <br />ILOAA <br />5. Zip Code <br />181524 <br />7. !Operator Name, if Different than Permittee <br />3. vfine Name <br />I11CILANE CANYON <br />I 2•o 1 <br />.0 <br />1 i0 1 <br />Pe <br />0 00' <br />a. Permit Review <br />b. Site Visit Time <br />c. Travel Time <br />d. Report Writing <br />Pu ose Type Codes - item 12 <br />Ox ..Oversight <br />Axx .Assistance <br />Sit Status - Item 15 <br />ND No Disturbance. No coal mining and reclamation <br />operations have been started. <br />EX al Exploration: Coal exploration operations have <br />farted and where coal mining operations have not <br />gun. <br />AP Active Coal Producing: Coal surface mining <br />ties are occumng. <br />AN pctive Non - Producing: Active non - producing facility <br />Much as tipple or preparation plant <br />NM o Mining: The Permit Status is active, site is not in <br />emporary Cessation, no surface coal mining <br />ctivity, and site not regraded. <br />U.S. DEPir. OF THE INTERIOR <br />OFFICE OF SURFACE MINING <br />Mine Site Evaluation <br />State Program <br />6. Phone Number <br />(9 70) 858 -3960 <br />4. State <br />IcoI <br />26. Signature Block <br />Signature' <br />Christine Belka, ID #182 <br />Printed Name: <br />Date: 14/5/2013 <br />it Type - Item 10 IP = Interim Program PP = Permanent Program NP = No Permit <br />RFx..Reclamatoh Fees <br />Fxx._Federal Actions <br />Fac ity Type Codes - Item 16 D ..Ancillary (Haulroad, Conveyor, and /or Rails <br />A.... urace E....Refuse and/or Impoundment <br />F....Loading Facility and /or Tipple <br />B ... nderground <br />C ...'reparation Plant G ...Stockpiles <br />9. Permit Number <br />1C <br />11. Field Visit Date 12. Purpose <br />13/26/2013 <br />14. Permit Status <br />IA <br />17. OSM Office 4 <br />1140 <br />105 -03012 <br />1056339 <br />MC Mining Complete: No mining activity on sae, site <br />regraded and awaiting bond release. <br />TC Temporary Cessation: The RA has granted <br />cessation of mining pursuant to 30 CFR <br />818/817:13(b). <br />P1 Phase I Release: At least Phase I bond release <br />granted for entire permitted area. For interim <br />permits, partial bond release. <br />P2 Phase II Release: At least Phase II bond release <br />for the entire permitted area. <br />P3 Phase III Release: Reclamation completed and <br />the RA has released at bond. <br />11...Exploration Permits <br />I....Notice of Intent to Explore <br />J...,Exempt 16 and 2/3 <br />IoPI <br />15. Site Status <br />IAN 1 <br />13. CCID <br />20. M.S.H.A. ID 4 21. State Abbrev. <br />CO <br />23. AVS Permittee Entity ID Number <br />27. R _. a "ns Official: <br />Signature: <br />Review Date: <br />Joint Inspection - Item 13 A )oint inspection is when a state inspector accompanies an OSM inspector at any time dunng the review of the mine site <br />10. Permit Type <br />IPP 1 <br />13. SRA Present <br />1 - <br />16. Facility T pe <br />19. Land Code <br />IF <br />22. Court /Burrough <br />24. State Office <br />mm - dd • yyyv <br />Is Supplemental MSE Page Used YIN n <br />CCR..Citizen Complaint Referral (non -site visit <br />CC Citizen Complaint (initial site visit) <br />CCF Assistance <br />Pe it Status - Item 14 AS Abandoned: All surface and underground coal mining activities have ceased and operator <br />A ive: Coal mining activities occurring or permitted but not yet has left the site without completing reclamation as defined in 30 CFR 840:11(g). <br />disturbed. AB1 Bond Forfeiture: Bond forfeiture officially in process or completed and reclamation in <br />IN Inactive (Permanent Program Permit). Phase II completed or progress or not yet commenced. <br />emporary Cessation of Operations. (Intenm Program Permit): AB2 Partially Reclaimed Forfeiture: Forfeited site where all bonds have been used to reclaim site, <br />I mining completed and reclamation activities initiated. but site not reclaimed to Program standards. <br />BR Bond Release: Reclamation completed and State Regulatory AB3 Reclaimed Forfeiture: Forfeited site that has been reclaimed to Program standards. <br />lhority(RA) has released all of the bond (Phase III Release). NA Not Applicable: When site is unpermitted. <br />NS Non-Site Visit Status of site not determined. <br />Forfeiture Pending: The RA is pursuing actions to <br />FP revoke the permit, collect the performance bond(s), <br />and/or reclamation of forfeited site is in progress. <br />FR Forfeited and Reclaimed: Forfeiture reclamation <br />completed. <br />FO Abandoned Site: Abandoned site that is permitted but <br />there is no bond. <br />WC Wildcat Coal mining and reclamation operations have <br />or are taking place and the activity is not covered by <br />the required permits from the RA <br />K....Govemment Financed Construction Exemption <br />L...Remining site permitted under 30 CFR 785 25 <br />Small Business Regulatory Enforcement Fairness Act (SBREFA) <br />Your Comments are Important <br />The Small Business and Agnculttrre Regulatory Enforcement Ombudsman and 10 Regional Fairness Boards were established to receive comments from small businesses about Federal agency <br />en`e cement aebcns The Ombudsman will annually evaluate the enforcement amvites and rate each agency's responsiveness to small business If you are a small business (a business will 500 or <br />fever employees ■duting those of affiliates) and man to comment cn the enforcement or ccmptance acsvlbes of OSM, call 1- 88S-REO -FAIR (t-8S&734 -3247) <br />Page 1 <br />