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;1.. K. s. <br />.. Av r, 1fit1R <br />III IIIIIIIII IIII•III <br /> A <br />United States Department of the Interior ~Np R <br />M1K~ Gl <br />~ffic <br />1 e Use ORIy <br />Office of Surface Mining ~ Na <br />~• Ke <br />la 1D 1c <br />Mine Site Evaluation Inspection Repor~~~• ~ m m <br /> Y Y M M Batch Report <br />2. Noma of Permittee ~ /' ~-- / . ~ i .. <br />9. MSHA Number 10. Date of Inspection <br />(V V M M D D) <br /> I _ ~ ~ - U / <br />/ - ~ / n ~ -v ~ l ) <br /> 3. Street Address t1. State Permit Number <br /> <br /> <. Cily 5. State t2. Name of Mine <br /> J ~ I <br />6. Zip Code 7. Area Code B. Telephone Number 73. County Coife 1a. State Cade ~ <br />15 <br />Str <br />ota fate Area Office <br />16. S <br />~J • cL - --- i ~ I' <br />i <br />~T <br />' r ~ ~ '.~1J / <br />~ I <br />17. OSM Field 18. OSM Aree 19. OSM 20. Type of Inspection 21. Joint Inspection 22. Inspector's ID <br />Olfice No. Offlca No. Sample No. <br />a ~ (Cotle) Yes No <br />a n <br />~ No. <br />~ <br /> . <br />23. Statue 24. Type of Activity (c.'teck applicable boxes). <br />A ~) Type of Permil <br />A Steep Slope <br />E ~ Anlnracite <br />B ® Mlne Status (Code) <br /> <br />r <br />B ~ Mountain Top Removal <br />F 1~! Federal Lands <br />~~1 <br />Type of Facility (Cotle) <br />C <br />m C ~ Prime Farmlantls G ~ Intllan Lands <br />D `~ (: i J ~ • Number of Permittetl Acres D ~ Alluvial Valley Floors H ~ Other <br />E /' ~ / _, 1 • Number of Disturbed Acres <br />25. Performance Standards (Codesl <br />In•tructlonc Indicate compliance code. For any standard marketl 2 or 3 provide narralrve in support this determination. <br />Slantlalda Thef Limit the Elfects to the Permil Area Slandartls That Assure Raclamahon Ouahty and Timeliness <br />A ~ Distance ProhlEitlons M ~ Topsoil Handling <br />B © Mining Wlihln Permit Boundaries N © Back!illing and Grading <br />C ~ Signs and Markers O ~ Following Reclamation Schetlnle <br />D ~ Sediment Conlrol Measures P ~ Ravegetation Requirements <br />E ~ Design end Certlllcallon Requirements- O W Disposal of Excess Spoil <br />~u <br />Sediment Control R ~ Hantlling of Acid or Toxic Materials <br />F ~ Effluent Llmlts <br />S ~ Highwall Elimination <br />G ~ SuAace Water Monitoring <br />T ~ Downslope Spoil Disposal ~'n," u <br />H ~ Ground Water Monitoring `-~ <br />U ~ Post Mining Land Use ~ .. - <br />j Imo/ ~ - <br />I ~ Blasting Procetlures <br /> V ~ Cessation of Operations: Temporary <br />J ~ Haul/ACCeae Roatl Design and Malnlenanca <br /> <br />K ~ Refuse ImDOUntlmenta ' -^ -~-i ~ - • •~ <br />. W ~ Otner <br />. <br />, <br />!Jn~' ~ ,.' .... <br />L ~ Other: Specify J <br />Dlatrlbutlan: Original ~ Fleltl Ofllca, Green <br />~~~~a~~~ <br />Headquarte lue - Slate'S Co , <br />Yellow ~ InspeClOr's Copy. Pink -File Cppy IE - 163 (1/(i3) <br />