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C <br />Monument Dam <br />Inspection Form <br />Date: <br />Time: j/ UD ry,,J? <br />Name of Inspector: /ZYII <br />Current Panel Being Mined: ?_?I - ,?c r3 <br />? Weekly Inspection 'pKMonthly Inspection <br />Yes No <br />? <br />o? <br />? IN <br />? Are there signs of seeps on the dam? <br />If yes, indicate where and estimated flow. <br />? P( <br />Is mining within I mile of Monument Dam? <br />Are there visible surface cracks on the dam? <br />If yes, indicate length and size of crack. <br /> <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 />5,1voV co ve,?!_e <br />Are there any other potentially damaging features on the dam? <br />If yes, describe. <br />? rX 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 />?Ivd t.J cUV F_ VC,_ F '0 <br />Notes: <br /> <br />Signature of Inspector: <br />Inspections are performe inde, ion of Michael J. Peacock, P.E. <br />-If cracks or other potentially damaging features occur, notify Ryan Sweetwood or <br />Wendell Koontz immediately.