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6~7 <br />l0liiaaiang .A~ea <br />Date Inspected <br />Impoundment , <br />~'t~~f~'~~~~~ <br />c5 0 <br />Te~~~~,~ <br />Are there any appearances of erosion, instability, structural weakness or other <br />hazardous conditions? h c~ <br />If yes explain: <br />Are there any existing and required monitoring procedures and instruments? ~l. f) <br />If yes explain: <br />The depth and elevation of any impounded waters at the time <br />(,(~ a d •2 V• ~Q. V Q' ~ ~~e¢ i~ b e. l0 ~.,~ lp y o ttic : l( 4 <br />Existing storage capacity of water in the impoundment (from ~ <br />spillway). G Ir2~a~2ti dG-w„` S ~Q~~ o~ cQe(~`El'~. do <br />Required <br />spillway). <br />ai <br />o~~~Po~~ <br />of water in the impoundment (from principal <br />0 <br />Any other aspects of the structure affecting stability, or requiring <br />maintenance. ~ O <br />Has structure been maintained as designed and in accordance with the approved plan <br />and the applicable regulations? <br />If no explain <br />\\\~~~~~~~111111I I i I illl/// ~~~ <br />/, <br />~``~~\ P~~ REC~S/~~''~ <br />~~ .•5 M..e~...•~~ i <br />-U~. 172 / <br />~~ti~. ~ <br />~` <br />%~j//////S/ONAI <br />F~ <br />lllllllll I I I <br />PROFESSIONAL ENGINEERS STA TE!'vr"ENi <br />l stcte that this pond wos i;~spected <br />and surveyed under my supervisior <br />and all the information presented <br />hereon is true and correct to the <br />best cf my knowledge and <br />in formation. <br />Z ~ 2 --off ~ • _ _ <br />Date Curtis M. Belden, ~'O P. E ?727~f <br />