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Indications of potential failure or instability: <br />IVo Ev;~P:°Nc~ o~ ~'ehs:o~-, crz?cks, ems. w4s ebf~r~. <br />Threat to human life or property: <br />~~'lur~ Gould e-~{cc~ P+`fso~s <br />o~ ~ofs; ply sr~~e /><y~usy ~a. <br />or err; p.~,~H~ Q~~ acc~ t 7`~- /~~% <br />Potential harm to land, air, and water resources: <br />~%~ure Co«(~ ~ec t ~i~ Iz{ ~c yo~y le%uer <br />Maintenance Required: <br />We ,reco~,e„aP a Prmm~ia// u5%h~ ~iPSivy t_pa%P/~ie•,t ~~ ~Pe.,s,7y ~.sfs <br />be ~er~o~~p~ w17~, ~st ~S ~io~P~escr7` rhaa~K~'otiv/ ~// s~io~/vr <br />nay b~ p/vc~~P l.~n ~%~ d~,sy~ ~sx~•~y 1s {~~r~{ac,~,~.~ <br />Supporting Documentation (Compactiontests, surveys, photographs, othermeasurements): <br />Inspector <br />Date <br />Send to: Colorado Division of Minerals & Geology within 2 weeks of quarterly inspection <br />(4.09.1(11)(b)). <br />'See 4.0911(c) for additional requirements. <br />Job No. 28,170 Page 2 of 2 <br />