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:~ <br /> <br />. ~~EIVED <br />I~~ I~II~II~~IIIII~I <br />Pdge 1 m .. ,~_ <br /> MAR 0 <br />United Slates Depacirnent Af the'iMerior Mined nd For offic e use Only <br />©ffiee'of Surface Mining iamatio <br />Mine Site Evaluation InspectipR Report F~eG Divi n ,b ,q <br /> <br /> . ':~~ .Y Y M M aatcn ReDOn <br />_o.. - - 10. Dale of Inspection <br />2. Name of Permiltee ~ 9. MSHA NUmbef. ~° ~" (V Y M M D D) <br /> <br />r <br />I <br />r <br />~` <br />iP.~ ~ - ~ <br />3. Street Address 11. State Permit NumbeF - ~ ~~ <br />' <br /> r r I ~' <br />~' , <br />f 5. State <br />1. City 12. Name of Mine <br />_ <br />~q ~ ~~~~~~~~~~~~~ <br />Irr a{11 I I ~ I t i~~~,.~.. <br />6~~Zlp~ Code 7. Area Cotle 8. Telephone 6lumber <br />LSI.LLL1]-CtJ~ "^ ~ I1I1/3~'. I'C~oul nety'f Code II(l/d1: L1~S~taf#te Code 15. Strata <br />~(~J ~Y3,,.y. .: .. m I16~Slave .4rca Office <br />IOW <br />17. OSM Fleltl 18. OSM Area 19. OSM 20. Type bf lr.SpeaB~?yi3~fTf(}l11k~t6PecUon - 22. 1nsDeaor's ID' . <br />1'IO/I1Nf'~c-~e No. OIIICe No. Sample No. (~COde)~~ ~ "NCS N`o~~ <br />23. Status ~ ~~ 26. type bf Acrivi4r,'dp'plfCatle COxes). <br />A rn TYPe of Permit <br />4 <br />~- <br />~ ~ +.. ~ ' ~ :•GCr,'_.. <br />~ A ~ ~~,'~D~~+VB ~ - <br />E ~ Antnracile <br />~ <br />- <br />1 <br />eI 1 1 1 Mine Status (Code) ~ <br />`MY'--~"' ~ ~~ '- -'~ <br />g ~ MdLmK,~i~Tep Removal ~~ <br />F ~ . Federal Lands <br />C ~ Type bf Facility (Code) ~ , <br />C ~ Prjrpe Farmlands <br />G ~ ~ Indian Lands <br />D r • Number of Permitted Acres ~ ~~ <br />~~©'." ^ AllOvidl YlfLlOy Floors <br />H ~ Other <br />~,~~~ <br />E L[JJCU-L~l_t-~11-~ Number of Disturbed AGreS :+~. ~ s . <br />25. Performance Standards fCodesl~~ <br />In•lruetbn•: Indicate compliance code. For any Standard marked 2 or 3 provide narrative to Support this determination. <br />Standards Thal Limit the Effects to the Ferrtlit'Arsa "~ Slantlards That Assure Reclamation Quiflily dnd Timeliness <br />Distance Prohibitions - ~ ~ _ , <br />A M ©Topsoil HaifAtRli3' <br />~ <br />B Mining Wlthlri Permit eouddaries ~ N i . { B~ck!81)rtt}-'dB~,G~ding <br />C ~ Signs antl Markers ~ O i~ Following Reclamation Schedule <br />V <br />-~ <br />D ®Setliment Control Measures Reveyetatinn Requirements ~ <br />P <br />n . <br />E n Design and Cerliflcation Requirements- ~ <br />~vt-J~ O Q Disposal of F~ktess Spoil <br />V' ~~ <br />Sediment Control ~~ <br />°R ~ Q Handling of AC~d of Toxic Materials <br />F ~ Effluent Llmlts ~~ <br />S a Highwall Elimina{fun <br />G ~ Surface Water Monitoring ~ .- <br />T Downslope Spoil Disposal <br />H ~ Ground Water Monitoring - <br />U ~ Post Mining land Use <br />1 i~ elasling Procedures <br />LfJ <br />V ~ Cessahon of Operations: Temporary <br />J ~ HaullACCess Roatl Design and Maintenance <br />W n Other <br />`7-' - <br />K Refuse lmDOUntlments <br />L O Other: Specify <br />Distribution: Original -Field Olf ice, Green -Headquarters, Blue ~ State's Copy. Yellow ~ Inspector's Copy Pink. ~ File Copy IE - 163 (1183) <br />. ~ F 4>ifa .a"1'P~L. <br />