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BASIN RESOURCES, INC. <br />SEDIMENTATION POND INSPECTION FORM <br />Date of <br />EMBANKMENT <br />1. Adequary of the vegetative cover: <br />2. Erosion forming gullies: <br />~~ NPDES No. ~ :~~ <br />c c~ <br />Excellent, odera[e Few, Poor <br />Extensive, Some, ~ryF}w, None <br />3. Is wave action causing erosion: <br />On the upstream embankment? ~r Yes No y <br />At the principal spillway inlet? ~y~ 5~r1lwot~ Yes No <br />4. Erosion of the do~mstream toe of the embankment? <br />The cause of the erosion is attributed to: <br />Yes No v <br />5. [s seepage occurring through the dam? <br />Could this seepage cause potential instability? <br />PRINCIPAL SPILLWAY /1/, S~:II~~K~' <br />1. Is the principal spillway system in working order? <br />2. Is the inlet free of debris and restrictive material? <br />Yes No ~ <br />Yes No _ _ ___ <br />Yes No <br />Yes No <br />3. Is the discharge outlet free of restrictive material? Yes No <br />4. Is erasion occurring at the discharge ou[Jet'? Yes No <br />Evaluate the severity: Extensive Moderate Just Staring None <br />EMERGENCY SPILLWAY N- S~--t~~v~y <br />1. Is the overall emergency spillway system capable of pa sing design storm discharge? <br />Yes No <br />2. Does i[ appear as if the emergency spillway has discharged water since the last inspection? <br />Yes No <br />3. [s erosion occurring at any section of the emergency spillway? Yes No <br />Describe the extent: <br />SEDIMENT STORAGE CAPACITY <br />1. Has the design storage capacity of [he re er <br />If yes, explain: F:+..i( rS ~~e <br />been surpassed? Yes No ~ <br />Please add any special comroeots concerning potentially dangerous problems oo the back of this <br />sheet! ~'~ <br />Inspected by: /~-~"~-/- <br />