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Monument Dam <br />Inspection Form <br />Date: 7/i'�;t�, <br />Time: / F <br />Name of Inspector: r/ <br />Current Panel Being Mined: tGG�/(r. a<' t <br />❑ Weekly Inspection b Monthly Inspection <br />Yes No <br />❑ [7 Is mining within I mile of Monument Dam? <br />❑ 10 Are there visible surface cracks on the dam? <br />If yes, indicate length and size of crack. <br />❑ q Is there evidence of subsided areas on or around dam? <br />If yes, indicate where and degree. <br />❑ D Are there bulges on the dam? <br />If yes, indicate where and degree. <br />❑ Q Are there signs of seeps on the dam? <br />If yes, indicate where and estimated flow. <br />■ �V <br />Are there any other potentially damaging features on the dam? <br />If yes, describe. <br />❑ O 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 />f <br />g P <br />Inspections are performed under the direction ofJessica Loveland, P.E. <br />-If cracks or other potentially damaging features occur, notify Jessica Loveland <br />immediately. <br />