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gtnek Pond <br />Inspection Form <br />Date: a i8 (lZ <br />Time: <br />Name of Inspector: <br />Current Panel and XC Being Mined: <br />Stock Pond(s) Being Inspected: <br />Yes No <br />❑ Is the stock pond within twice the projected angle of draw of <br />subsidence? If yes, which pond(s): <br />❑ ❑ 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 />❑ ❑ Is mitigation needed? If yes, list suggestions: <br />Notes:, �` <br />�QCCeS S. e e - 0 6N0 u, o+.,c,ol �-v,�d �O.t%G i /wvs• <br />C <br />Signature of Inspector: C;D— <br />* <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 />(WAMCC-Engineering\ENV PERMITTING\REG AGENCIES\CDRMS\Inspection-Survey USFS Ponds & Rds\Ponds\Stack Pond Inspection Forth) <br />