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Mining Area <br />Date Inspected <br />Impoundment <br />CAI r04 -2T - <br />Are there any appearances of erosion, instability, structural weakness or other <br />hazardous conditions? NO <br />If yes explain: <br />Are there any existing and required monitoring procedures and instruments? NO <br />If yes explain: <br />The depth and elevation of any impounded waters at the time of inspection. <br />4 .JAfrHE S <br />Existing storage capacity of water in the impoundment (from principal <br />spillway). /?/D <br />Required storage capacity of water in the impoundment (from principal <br />spillway). I A <br />Any other aspects of the structure affecting stability, or requiring <br />maintenance. N o I-rc- <br />Has structure been maintained as designed and in accordance with the approved plan <br />and the applicable regulations? P 'S <br />If no explain <br />o\\O111IRI?1111//1j??wv <br />17274 <br />a <br />Y1111IT111111111111100 <br />PROFESSIONAL ENGINEER'-D STA TEMENT <br />l state that this pond was inspected <br />and surveyed under my supervision <br />and all the information presented <br />hereon is true and correct to the <br />best of my knowledge and <br />in form a Lion. <br />94 , QAZI(?_ <br />Date Curtis M. Belden, CO P.F 77,274