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Monument Dam <br />Inspection Form <br /> <br />Date: 31 q 1 0" <br />Time: ?k.')O P"" o? <br />Name of Inspector: ?Ly S G" Z <br />Current Panel Being Mined: t <br />? Weekly Inspection Monthly Inspection <br />Yes No <br />? q!` Is mining within 1 mile of Monument Dam? <br />? o Are there visible surface cracks on the dam? <br />V If yes, indicate length and size of crack. <br />? ,p Is there evidence of subsided areas on or around dam? <br />If yes, indicate where and degree. <br />? 1/ 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 />Notes: <br />S IVC) W C 0 V F?Fo <br /> <br />Signature of Inspector: ti <br />Inspections are performed and t irecti ichael J. Peacock, P. E. <br />-If cracks or other potentially damaging features occur, notify Ryan Sweetwood or <br />Wendell Koontz immediately.