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J' ,. <br />.~ <br />Indications of potential failure or instability: <br />NO Si5 r15 oT M 4Sf -~,' ~U /' e O r , n5 )`~?'~~ ~i~y k2°/~ <br />7~~ ~i41/ Sc.r~lc slu~/~ oPocs Hof 4~~c fo <br />n <br />JQ17~rLt°d • ~J <br />~/' 1° ~tbr~rlt4i'- <br />Threat to human life or property: <br />~;~u~i; C®u~ ~~f rPe~ons ~~~ro~~~Y nc°q~ ~%l~ <br />Potential harm to land, air, and water resources: <br />!-q;1ur~ could v~~f ~~ ~~t~gfory Ic~~~r' , <br />Maintenance Required: <br />1. I~.Por ~ r Si" 14`/ S~u •_-~~ 4t~vG 3~~ ~ arc ~ 4S ~~c~~ <br />Supporting Documentation (Compactiontests,surveys, photographs, othermeasurements): <br />T~~~~ .~ <br /> :, ..:- . <br /> <br /> <br />Inspector SupevGising P. /~ g• ~'=-~ •-- >~",'' <br />Date <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 />