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<br />United States Department of the Interior <br />Office of Surface Mining SLP 3 ~ 1991 <br />Mine Site Evaluation Inspection~titeport <br />Mined Land <br />2. Name of Permittee <br /> <br />3. Street Address <br /> _ i ~ <br />4. City / 5. State <br /> <br /> n <br />8. Zip Cotle 7. Area Code 8. Telephone Number•.~s"'' <br /> ~ ~ ~ <br />i ~ s , <br />`III IIIIIIIIIIIIIIII~~' <br />Pape 1 pl Z Papea <br />For Office Use Only <br />,a ,b t~ <br />m <br />IY Y M M Batch Report <br />t0. Date of Inspecti <br />9. MSHA Number (V V M M D D) <br />L~ <br />` tat<, Permit Number) <br />t2. Name of Mine TT <br />13. County C5tlej3L~mI~S/tal~te Code ;~15m~Str lata 16. State Area Office <br />17. OSM Fleltl <br />Ofllce No. <br />~- 18. OSM Area <br />Office No. <br />~ 19. OSM <br />Sample No. <br />~ 20. Type of Inspectlor, ~ 21. Joint Inspection <br />(Code) ~ Ves No <br />~J ~ Cl _ _ 22. Inspector's ID <br />No. <br />23. Status d. Type of Actmity (check aDP hcoble coxes). <br />A m Type of Permit <br /> A L ~ Steep SIODe Q~' ~ i gnthrar,~te <br />B ~~ Mine Status (Code) ~ ~ u <br />F='J B ~ Mountain foP Rert~oral ~ r_~ Fnderal Lands <br />L <br />C m Type of Facility (Cotle) , <br /> C ~ Prime Farmlands 1 <br />Indian Lands <br />G C <br />D ~ Number of Permdted Arras J <br /> D ~ Alluvial Valley Floors H'' ~ Other <br />~ <br />E 1 1 1 1 T <br />1 1' I~ Number of Disturbed Acres <br />25. Performance Stantlartls (Codes) <br />Inatruetlona: Indicate compliance Cotle. For any standard marketl 2 0~ 0 provide narrative In support this determinahnn. <br />Standards That Limit the E/facts to the Permit Area Standards Tnat Assure Reclamahor, Oualily and Timeliness <br />A ~ Distance Hrohibitions <br />B ~ Mining Within Permit Bountlaries <br />C ~ Signs antl Markers <br />D ~ Sediment Control Measures <br />E ~ Design and Certification Requirements- <br />Setliment Control <br />F ~ Eltluant Limlis <br />G ~ Surface Water Moniloring <br />H ~ Ground Water Monitoring <br />I ~ Blasting Procetlures ~. 5: <br />J ~ Haul/Access Road Design and MaintenanDe <br />K ~ Refuse Impoundments , <br />L ~ Other: Specify <br />M 4J Topsoil Handling <br />N ~ Back!il l~uq anq Grading <br />O ~ Following Reclamation Schedule <br />P U Reveyetation Regwremenls <br />O ~ Disposal el Ezcess Spoil <br />, <br />'~ <br />- <br /> ~, <br />.. <br />. r <br />-. C_, ,K.1. <br />R ~ Handling of Acid or Toxic Materials <br />S ~ Highwall Elimination <br />T ~ Downslope Spoil Disposal <br />U ~ Post Mining Land Use <br />V ~ Cessation of Operations: Temporary <br />W ~ Other <br />Disiribuhon: Original ~ Field Office, Green ~ Headquarters, Blue ~ State's Copy. Vellow ~ Inspector's Copy Pink File Copy IE ~ 16317/83) <br />