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Monument ]Jam <br /> Inspection Form <br /> Date:4/2c-17-00 <br /> Time: 1 V-'3o Ar M <br /> Name of Inspector: D cpo-,-- rk-7- <br /> Current Panel Being Mined: LwE? <br /> ❑ Weekly Inspection ig Monthly Inspection <br /> Yes No <br /> ❑ 19 Is mining within I mile of Monument Dam? <br /> ❑ 0 Are there visible surface cracks on the dam? <br /> If yes, indicate length and size of crack. <br /> ❑ 0 Is there evidence of subsided areas on or around the dam? <br /> If yes, indicate where and degree. <br /> ❑ 19 Are there bulges on the dam? <br /> If yes, indicate where and degree. <br /> ❑ 19 Are there signs of seeps on the dam? <br /> If yes, indicate where and estimated flow. <br /> ❑ x Are there any other potentially damaging features on the dam? <br /> If yes, describe. <br /> ❑ 0 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: /V`'T <br /> Inspections are performed under the direction of John Poulos, P.E. <br /> If cracks or other potentially damaging features occur, notify John Poulos or Kathy Welt <br /> immediately. <br /> (WAMCC-Engineering\ENV PEFMITTING\REG AGENCIESTDRMSWonument Dam\Monument Dam Inspection ProcedureMonument Dam Inspection Form) <br />