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Monument Dam <br />Inspection Form <br />Date: A(gd?116 <br />Time: 1()53o Name of Inspector: <br />Current Panel Being Mined: j <br />? Weekly Inspection A Monthly Inspection <br />Yes No' <br />\0 ? Is mining within 1 mile of Monument Dam? <br />? ? <br /> <br /> <br /> <br />Signature of Inspector: G <br />Inspections are performed un , e t irq ion o ichael J. Peacock, P.E. <br />64A?r <br />'j;V'&<_ <br /> <br />Notes: <br /> <br />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 />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 there any recent evidences of slope failure on the landside south of the <br />dam (perform visual inspection and data analysis of inclinometers)? <br />If yes, describe. <br />-If cracks or other potentially damaging features occur, notify Ryan Sweetwood or <br />?_ Wendell Koontz immediately.