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Monument Dam <br />Inspection Form <br />Date: 77// <br />Time: 3 �� <br />Name of Inspector: ��; L.u- %Gcn�✓ lv /.f�`Gti' �7 /-,T <br />Current Panel Being Mined: ES V( (`0 <br />❑ Weekly Inspection n Monthly Inspection <br />Yes No <br />❑ 10 Is mining within I mile of Monument Dam? <br />■ ■ <br />❑ b <br />Are there visible surface cracks on the dam? <br />If yes, indicate length and size of crack. <br />Is there evidence of subsided areas on or around dam? <br />If yes, indicate where and degree. <br />❑ l Are there bulges on the dam? <br />If yes, indicate where and degree. <br />❑ [ Are there signs of seeps on the dam? <br />If yes, indicate where and estimated flow. <br />Are there any other potentially damaging features on the dam? <br />If yes, describe. <br />❑ t� Are there any recent evidences of slope failure on the landside south of the <br />dam (perform visual inspection and data analysis of inclinometers)? <br />If yes, describe. <br />Notes: <br />Signature of Inspector: <br />Inspections are performed under the direction of Jessica Loveland, P.E. <br />-If cracks or other potentially damaging features occur, notify Jessica Loveland <br />immediately. <br />