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<br />Indications of potential failure or instability: <br />L v,oL Lv/I c~ m-tC fetes; o•~ c ~~, tics , ~f~. W4s <br />L ~ J <br />~'Iv7"- o hSC~('uC <br />Threat to human life or/pnroperty:/~ <br />~~ ~u~~ Gou(~" ~~7~~ct P~~Sa~tS a~i' P~o~~~t~ 4~'QGe°.~f <br />-~, P;1~ <br />Potential harm to land, air, and water resources: <br />~Gi ~~ r ~ Cmu~~ q 7'~PGf rn~ r u/S afoTY F'~~ <br />Maintenance Required: <br />~on~ <br />Supporting Documentation (Compactiontests,snrveys, photographs, othermeasurements): <br />Supervising P. <br />~ ~1 <br />~~'! ~,\~ <br />c ~: ; r ~ r <br />~j~"i <br />~. r'• <br />~•~M <br />Send to: Colorado Division of Minerals 8 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 />~ ~~~o~ <br />Date <br />