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<br /> <br />Monument Dam <br />Inspection Form <br />Date: d j °? <br />Time: [' ' "N <br />Name of Inspector: (L. " .,:) ( J u ?yo 6 <br />Current Panel Being Mined: q?[ <br />? Weekly Inspection ' ?'Monthly Inspection <br />Yes No l ` <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 />? 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 />? V A 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 />Notes: <br />5 /V o W C??4 t:71- <br /> <br />Signature of Inspector1/ ` <br />Inspections are per/or u)ii <br />-If cracks or other potentially <br />Wendell Koontz immediately. <br />chael J. Peacock, P. E. <br />occur, notify Ryan Sweetwood or