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Mining Area <br />Date Inspected <br />Impoundment <br />Are there any appearances of erosion, instability, structural weakness or other <br />hazardous conditions? 1'I (~ <br />If yes explain: <br />Are there any existing and required monitoring procedures and instruments? ~ O <br />If yes explain: <br />The depth and <br />of any impounded waters at the time of inspection. <br />Existing storage capacity of water in the impoundment from principal <br />spillway. ~o (.~ ac, ~d . <br />Required <br />spillway. <br />capacity of water in the impoundment (from principal <br />S~ ~~«~ <br />~-I~l-o6 <br />PQ4CoGo <br />Any other aspects of the structure affecting stability, or requiring <br />maintenance. In t~ <br />Has structure been maintained as designed and in accordance with the approved plan <br />and the applicable regulations? <br />If no explain ___ <br />o~~~~~°~0~ REG~""'~~io~ <br />O~P° P • <br />\ NETT ST~~ <br /> <br />;, <br />O <br />%: <br />~ <br />• <br />U i ~ <br />-o ; 18 A <br />: <br />406 : ~ <br />=A: :cum <br /> <br />~~iiununnmi~~ <br />PROFESSIONAL ENGINEERS STA TEMENT <br />l state that this pond was inspected <br />and surveyed under my supervision <br />and all the information presented <br />hereon is true and correct to the <br />best of my knowledge and <br />/ in fy~rmotion.~,~~ /~~-- <br />fz i~ o~ jam/ /y.J"- <br />Dote David A. Hettinger CO PE 78406 <br />