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U.S. DEPT. OF THE INTERIOR <br />OFFICE OF SURFACE MINING <br />Mine Site Evaluation <br />State Program <br />A <br />IZ: D! <br />oENTOFT <br />t <br />1. Permittee/Persdn' <br />C.B. MINERALS COMPANY, LLC <br />2. Address <br />18717 DELGANY AVE, APT. 215 <br />3. City <br />(PLAYA DEL RAY <br />5. Zip Code <br />190293 <br />7. Operator Name, if Different than Permittee <br />8. Mine Name <br />6. Phone Number <br />1(831) 625 -5886 <br />4. State <br />1 CA 1 <br />1COAL RIDGE #1 <br />9. Permit Number <br />IC- 065 -84 <br />11. Field Visit Date 12. Purpose <br />19/11/2012 <br />- ad - my <br />14. Permit Status 15. Site Status <br />IBR 1 <br />17. OSM Office # <br />1140 <br />20. M.S.H.A. ID # 21. State Abbrev. 22. Coun <br />105 -03718 <br />1056926 <br />IOC <br />IP 2 1 <br />18. CCID # 19. Land Code <br />CO <br />10. Permit Type <br />IPP <br />13. SRA Present <br />IYI <br />16. Facili T pe <br />Is <br />/Burrough <br />23. AVS Permittee Entity ID Number 24. State Office <br />25. Hours <br />I 1.0 I <br />I 1.0 1 <br />I 5.0 I <br />1 3.0 1 <br />a. Permit Review <br />b. Site Visit Time <br />c. Travel Time <br />d. Report Writing <br />Purpose Type Codes - Item 12 <br />Oxx.. Oversight <br />Axx ..Assistance <br />Joint Inspection - Item 13 A joint inspection is when a state inspector <br />Permit Status - Item 14 <br />A Active: Coal mining activities occurnng or permitted but not yet <br />disturbed <br />IN Inactive (Permanent Program Permit) Phase II completed or <br />Temporary Cessation of Operations (Intenm Program Permit): <br />Coal mining completed and reclamation activities initiated <br />BR Bond Release Reclamation completed and State Regulatory <br />Authority(RA) has released all of the bond (Phase III Release) <br />Site Status - Item 15 <br />ND No Disturbance: No coal mining and reclamation <br />operations have been started. <br />EX Coal Exploration: Coal exploration operations have <br />started and where coal mining operations have not <br />begun <br />AP Active Coal Producing: Coal surface mining <br />activities are occumng. <br />AN Active Non - Producing Active non - producing facility <br />such as tipple or preparation plant. <br />NM No Mining. The Permit Status is active, site is not in <br />Temporary Cessation, no surface coal mining <br />activity, and site not regraded. <br />26. Signature Block <br />RFx.. Reclam <br />Fxx...Federal <br />Christine Belka, ID #182 <br />Date: <br />Signature <br />Printed Name <br />19/27/2012 <br />Permit Type - Item 10 IP = Interim Program PP = Permanent Program NP = No Permit <br />ation Fees <br />Actions <br />MC Mining Complete: No mining activity on site, site <br />regraded and awaiting bond release. <br />TC Temporary Cessation The RA has granted <br />cessation of mining pursuant to 30 CFR <br />816/817 13(b). <br />P1 Phase I Release: At least Phase I bond release <br />granted for entire permitted area For intenm <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 all bond <br />27 : viewing O ici <br />.____ <br />„tt,de <br />S ignature: <br />Review Date: <br />1/ 0-- / - /Q 1 <br />mm - dd - yyyy <br />Is Supplemental MSE Page Used Y/N <br />CCR. Citizen Complaint Referral (non -site visit <br />CC Citizen Complaint (initial site visit) <br />CCF Assistance <br />accompanies an OSM inspector at any time during the review of the mine site <br />Facility Type Codes - Item 16 0 ..Ancillary (Haulroad, Conveyor, and /or Rails H Exploration Permits <br />A... Surface E.. .Refuse and /or Impoundment I . Notice of Intent to Explore L Remining site permitted under 30 CFR 785.25 <br />B ..Underground F... Loading Facility and /or Tipple J...,Exempt 16 and 2/3 <br />C... Preparation Plant G .. Stockpiles <br />AB Abandoned: All surface and underground coal mining activities have ceased and operator <br />has left the site without completing reclamation as defined in 30 CFR 840 11(g) <br />AB1 Bond Forfeiture Bond forfeiture officially in process or completed and reclamation in <br />progress or not yet commenced <br />AB2 Partially Reclaimed Forfeiture: Forfeited site where all bonds have been used to reclaim site, <br />but site not reclaimed to Program standards. <br />AB3 Reclaimed Forfeiture Forfeited site that has been reclaimed to Program standards. <br />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 />Small Business Regulatory Enforcement Fairness Act (SBREFA) <br />Your Comments are Important <br />The Small Business and Agnculture Regulatory Enforcement Ombudsman and 10 Regional Fairness Boards were established to receive comments from small businesses about Federal agency <br />enforcement actions The Ombudsman will annually evaluate the enforcement activites and rate each agency's responsiveness to small business If you are a small business (a business with 500 or <br />fewer employees including those of affiliates) and wish to comment on the enforcement or compliance activities of OSM, call 1- 888 -REG -FAIR (1-888 -734 -3247) <br />Page 1 <br />