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Monument Dam <br />Inspection Form <br />Date: <br />Time: <br />Name of Inspector: 1Z?ur S, rzc kwoor? <br />Current Panel Being Mined: F <br />? Weekly Inspection 1 Monthly Inspection <br />Yes No <br />? l Is mining within 1 mile of Monument Dam? <br />? 1 Are there visible surface cracks on the dam? <br /> If yes, indicate length and size of crack. <br />? Is there evidence of subsided areas on or around dam? <br /> If yes, indicate where and degree. <br />? Are there bulges on the dam? <br /> If yes, indicate where and degree. <br />? l Are there signs of seeps on the dam? <br /> If yes, indicate where and estimated flow. <br />? Are there any other potentially damaging features on the dam? <br />If yes, describe. ,/ /? <br />? Are thdAgA en0e%dence's of slope failure on the landside south of the <br />dam (perform visual inspection and data analysis of inclinometers)? <br />If yes, describe. <br />Notes: <br />Signature of Inspector: <br />Inspections are performed der t e diet 'on of Michael J Peacock, P.E. <br />-If cracks or other potentially damaging features occur, notify Ryan Sweetwood or <br />Wendell Koontz immediately.