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Stock Pond <br />Inspection Form <br />Date: 8 A 117 <br />Time: ' I I. tSp rv% <br />Name of Inspector:� ..� <br />Current Panel and XC I I eing Mined: Kc 1 c� <br />� <br />Stock Pond(s) Being Inspected:qp 5 <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 />❑ 11 Is there water in the pond? If yes, describe: <br />❑ ❑ Is mitigation needed? If yes, list suggestions: <br />Notes: <br />lN.4C.cG.ss <br />Signature of Inspector: <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\Stock Pond Inspection Form) <br />