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<br /> <br />~APRz2 ~g~~ <br />iii iuiiiiuiiu iii <br />999 <br />Pepe t o1 i P•pn <br />1 •II'1 rnl AllrT'n.~ <br />r~ ~~ _., ~ ._ .,.r ,..~,~. 1. 1 <br />!rislo~i <br />United States Department of the Interw4+L 6f ii~lla3: ~2i fCBS For Office Use Only <br />Office of Surface Mining <br /> <br />Mine Site Evaluation Inspection Report ,a <br />~ ,b ,~ <br />m m <br /> Y Y M M Balch Report <br />' 10. Data of Inspection <br />2 Name of Ixermltte• 9. MSHA Number (V Y M M 0 D) <br /> <br /> 3. Street Atltlrese 11. State Permit Number <br /> .~ .-F e1 i ,i - I <br /> 4. City 5. State 12. Name of Mlne <br /> <br /> r. •J ~ r - <br />8. Zip Code 7. Area Cooe 8. Telephone Number 13. Coun[y Cotle 14. State Cotle 15. Strata 18. State Area Ollica <br />~ 1- .. .' I - Y I m m <br />17. OSM Field 18. OSM Area 19. OSM 20. Type of Inspection 21. Joint Inspxtlon 22. Inspector's ID <br />Office No. Olfics No. Semple No. <br />m (Cotle) Yea No No. <br /> <br />23. Statue 24. Type of Activity (check applicable boxes). <br />A m Typa of Permit <br />A ~ Steep Slope <br />E ~ Anthracite <br />B m Mine Stelus (Code) <br />B ~ Mountain ToD Removal <br />F ~ Federal Lantls <br />C m Type of Facility (Code) <br />C ~ Prime Farmlantls <br />G ~ Intllen Lantls <br />D ~ , • ~; Number of Permllted Acres <br />D ~ Alluvial Valley Floors <br />H ~ Other <br />E - - _ • G Number of Disturbed Acres <br />25. Pertormance Standartls (Cotles) <br />In•buclbna: Indicate comDllence coos. For any standard marked 2 or 3 provitle narrative to suDDart This delerminetion. <br />Standards That Llmlt the Elfects to the Permit Area Stantlartls That Assure Reclamation Quality antl Timeliness <br />A ~ Distance Prohibitions M O Topsoil Handling <br />B ~ Mlnlnp Wllhln Permit Boundaries N ~ Backfilling and Gratlinp <br />C ~ Signs antl Msrkera O O Following Reclamation Schedule <br />D ~ Sediment Control Measure9 P ~ Reve9etallon Requirements <br />E ~ Design end Certlllcatlon Requirements- O I^ Disposal of Excess Spoil <br />Sediment Control <br />R ~ Handling of Acid or Toxic Materials <br />F ~ Elfluent Llmlte <br />S ~ Hlghwall Ellminatlon <br />G ~ Surface Water Monltoring <br /> <br />H ~ Ground Water Monltoring T ~ DownaloDe Spoil Disposal <br /> U a Post Mining land Use <br />I ~ Bleating Procedures <br /> V ~ Cessation of Operations: Temporary <br />J ~ HaullACCess Road Design and Maintenance <br /> W ~ Other <br />K ~ Reluse Impoundments <br />L ~ Other. SDeclry <br />DlstrlDutlon: Original -Field Ollice. Green - Headquart s, Blue -Slate's Copy, Ilow -Inspector's Copy, Pink - FII9 Copy IE - 783 (1183) <br />