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IIVOML# 1 IVIV KCrVK 1 "' IVU I n 1 AT LVKILL <br />(Including Both the East Taylor and West Taylor Fill Se ments) <br />INDICATE QUARTER —> 1sT ❑ 2ND 11 3RD ❑ 4TH ® 2015 <br />YEAR <br />ALL QUARTERS NEED TO BE CERTIFIED <br />THE FOLLOWING ITEMS ARE TO BE INSPECTED AND REPORTED AS NOTED: <br />1) Has any significant change been noted in the survey monumen�s on the fill? <br />No NA Yes <br />If yes, explain: <br />Date of Survey: <br />Reviewed By: Steve Weist Kurt Blunt <br />i <br />2) Has any significant change been noted in the water level found in the fill monitoring <br />well? <br />No X Yes Measured Level 225.7 feet If yes, explain: <br />Date of Measurement: _12/09/15 <br />Measured By: Steve Weist, Kurt Blunt <br />3) <br />4) <br />Has there been any evidence of surficial slope failure on the fa4e of the fill? <br />No X Yes <br />If yes, explain: <br />Date of P.E. Inspection: 12/09/15 <br />Inspected By: Steve Weist, Kurt Blunt <br />Has there been any formation of springs or seeps on the face o� the fill? <br />No X Yes <br />If yes, explain:__ <br />Date of Inspection: 12/09/15 <br />Inspected By: Steve Weist, Kurt Blunt <br />Reference Permit - Volume 13, Exhibit 21, Item 1, Introductory Pages <br />CF: HSEQ 24.20.04 i Revised Feb. 7, 2008 <br />