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<br />DAM NAME: <br />EXISTING INSTRUMENTATION FOUND 0 (110) NONE <br /> <br />01114) SURVEY MONUMENTS 011151 OTHER <br />MONITORING OF INSTRUMENTATION: 0 (116} NO 0 om YES <br /> <br /> <br />~o.E <br />_00 <br />!.'g <br />g.!!.i'~ <br />.i~-:: <br />~.O.!O <br />"O~~~~ <br />'.1:: _ <br />5 e ~1~ <br />,,0 0 <br />.'g.:: :I. <br />~ti~~e <br />o.!...~ <br />;::;.c _._ <br />~;:!:;:~ <br />i..E= <br />=5=~j <br />~oEe! <br />.!I::... <br />:g:! !'8 <br />E~: 0..2 <br />.r::..o- <br />"08e-o <br />.. .eo. <br />:E:_"C.o <br />... -: e: <br />O~t:. . <br />'::I-~. <br />~>oor:: ! <br />eil:'~~ <br />0....-- <br />:o..2'i ~ E <br />.c.P:~2 <br />...-.;::>- <br />:~:.e <br />=~.s!'=! <br />~~l:'~j <br />W.;:::"C_ <br />. e:i5:i 0 <br />~.~2~ <br />~ E 0-- <br />!;: i2 '5 <br />I- :!t: ~ <br /> <br />0(111) GAGE ROD <br /> <br />DAM 1.0.: <br />o (113) SEEPAGEWEIHS/FLU~ES <br /> <br />0(112) PIEZOMffiRS <br /> <br />PERIODIC INSPECTIONS BY: 0 (118) OWNER 0 (119) ENGINEER <br /> <br />Comments: <br /> <br />PROBLEMS NOTED 01601 NONE 0 (61) ACCESS ROAD NEEDS MAINTENANCE 0 (62) CATTLE DAMAGE <br />o (631 BRUSH ON UPSTREAM SLOP~ CRESI ~OW,NS~R~M SLOPE.. TOE 0 (54) TREES ,D,N YPS~REAM SLDP~ ,CREST. DDWNST~EA.M .SLDPE" TOE, <br /> <br />o (65) R.~~.~N.~ .'~~~.~1.~1.1!. ~~. .~~~.~~.~~. ~.~~.~~: .~~~~.~'. ~.~~~~~.~~~ .~.L.q~.~,. ~.~~. 0 (66) ~.~~.~I.~~~~P. C.~~~~~!~..~~~I.~~.. ~~!.~~: .~~.I~~~~~. <br />o (67) GATE AND OPERATING MECHANISM NEED MAINTENANCE 0 16B) OTHER <br /> <br />Coml'T'leflts: <br /> <br />REMARKS: <br /> <br />Based on this Safety In$peCtion and recent file review. the owrall toodtuon is determined to be: <br /> <br />071 SATISFACTORY <br /> <br />072 CONDITIONALLY SATISFACTORY <br /> <br />ITEMS REQUIRING ACTION BY OWNER <br />TO IMPROVE THE SAFETY OF THE DAM <br /> <br />073 UNSATISFACTORY <br /> <br />...IITElUCE . 11101 IEUII . MalITtlIII' <br />o (80) PROVIDE ADDITIONAL RIPRAP: <br />0(81) LUBRICATE AND OPERATE OUTLET GATES THROUGH FULL CYCLE: <br />o (82) CLEAR TREES AND/OR BRUSH FROM: <br />0(83) INITIATE RODENT CONTROL PROGRAM AND PROPERLY BACKFILL EXISTING HOLES: <br />0(84) GRADE CREST TO A UNIFORM ELEVATION WITH DRAINAGE TO THE UPSTREAM SLOPE: <br />o (B5) PROVIDE SURFACE DRAINAGE FOR <br />o IB6) MONITOR: <br />o (8n DEVELOP AND SUBMIT AN EMERGENCY PREPAREDNESS PLAN. <br />OIBB) OTHER, <br />o (B9) OTHER <br /> <br />DATE I I <br /> '" <br /> ~ <br />0 m . <br />"' <br />8 I;: ~ <br />w <br />" u <br /> u <br /> "' <br /> <br /> <br />w <br />~ <br />.. <br />o "' . <br />01;:8 <br />g ~ 0. <br />U <br />"' <br /> <br />nGlnEIIIIS - UIPLor Al ElSlIIEEI UPUIUCEB II QUI5I Ug COUTlUCTlOI OF DillS TO: (Plans & Specillcalion must be approved by State Engineer prior 10 cOrlStruclion.) <br />0/90) PREPARE PLANS AND SPECIFICATIONS FOR THE REHABILITATION OF THE DAM: <br />0(91) PREPARE AS-BUILT DRAWINGS OF: <br />0(92) PERFORM A GEOTECHNICAL INVESTIGATION TO EVALUATE THE STABILITY OF THE DAM: <br />o (93) PERFORM A HYDROLOGIC STUDY TO OmRMrNE REQUIRED SPILLWAY SIZE: <br />01941 PREPARE PLANS AND SPECIFICATIONS FOR AN ADEOUATE SPILLWAY: <br />0(95) SET UP A MONITORING SYSTEM INCLUDING WORK SHEETS, REDUCED DATA AND GRAPHEO RESULTS: <br />o (9fi) PERFORM AN INTERNAL INSPECTION OF THE OUTlET: <br />0(97) OTHER <br />01981 OTHER <br />o 1991 OTHER <br /> <br />0(101) <br />0(102) <br />01103) <br /> <br />SAFE STORAGE lEVEL RECOMMENDED AS A RESULT OF THIS INSPECTION <br /> <br />_FT. HE lOW DAMS CREST <br />{_FT. BELOW SPILLWAY CREST <br />_ FT. GAGE HEIGHT <br />=NO STORAGE-MAINTAIN OUTLET FULLY OPEN <br /> <br />FULL STORAGE <br />CONDlTIONAl FULL STORAGE <br />RECOMMENDED RESTRICTION <br /> <br />RESTRICTED LEVEL <br />OFFICIAL ORDER TO FOLLOW <br /> <br />REASON FOR RESTRICTION <br /> <br />ACTIONS REOUIREO FOR CONDlTlONAl FULL STORAGE OR CONTINUED STORAGE AT THE RESTRICTED LEVEL. <br /> <br />El'glllterS <br />Signature <br /> <br />Owners <br />Signature <br /> <br />DATE: <br /> <br />/ / <br />