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Monument Dam <br />Inspection Form <br />Date: I"'6 <br />Time: <br />Name of Inspector: TZ?u N S?.xzL Fw oc? <br />Current Panel Being Mined: F <br />? Weekly Inspection ? Monthly Inspection <br />Yes No <br />? ii Is mining within 1 mile of Monument Dam? <br />?1 Are there visible surface cracks on the dam? <br />If yes, indicate length and size of crack. <br />?i 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 />?f Are there any other potentially damaging features on the dam? <br />If yes, ,,d,,??escribe. <br />El Are tht?feqen???? <br />t"dViden es 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 />Signature of Inspector: ?-- -- -`? <br />Inspections are performed dertlie d'rec "on of Michael J. Peacock, P.E. <br />-If cracks or other potentially damaging features occur, notify Ryan Sweetwood or <br />Wendell Koontz immediately.