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Stock Pond <br />Inspection Form <br />Date: //1 g /1 -Z <br />Time: 3, 15 F i <br />Name of Inspector: <br />Current Panel and XC Being Mined: L% (Q )(0- ZI <br />Stock Pond(s) Being Inspected: 'P q6 ,- J <br />Yes No <br />❑ [� Is the stock pond within twice the projected angle of draw of <br />subsidence? If yes, which pond(s): <br />❑ 14" Are there visible surface cracks in or near the stock pond? If yes, <br />describe (location, width, length, etc.): <br />❑ Is there any evidence of potential subsidence induced water loss? If <br />yes, describe: <br />❑ ❑ Is there water in the pond? If yes, describe: <br />❑ H"- Is mitigation needed? If yes, list suggestions: <br />Notes: <br />Signature of Inspector-7�iP"� <br />* If any potential subsidence induced features are observed that could cause harm <br />to the pond, notify Mike Peacock or Kathy Welt immediately. <br />(W \MCC-Engineering\ENV PERNIITTING\REG AGENCIES\CDRMS\Inspecnon-Survey USFS Ponds & Rds\Ponds\Stock Pond Inspection Form) <br />