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Mining Area <br />Date Inspected <br />Impoundment <br />1 <br />U U °? <br />Are there any appearances of erosion, instability, structural weakness or other <br />hazardous conditions? C) <br />If yes explain: <br />Are there any existing and required monitoring procedures and instruments?_ <br />If yes explain: <br />Required storage capacity of water in the impoundment (from principal spillway, in <br />acre-feet).- q -5 <br />Any other aspects of the structure affecting stability, or requiring <br />maintenance. VLy <br />Has structure been maintained as designed and in accordance with the approved plan <br />and the applicable regulations? qmk4l <br />If no explain <br />p00 • REG/, /// <br />o ; 26046 <br />L'j <br />/ONAL <br />IIIIIIIIIIIIN <br />PROFFSSIONAL ENGINEER'S S TA TFMFN T <br />l state that this map was prepared <br />under my supervision and all the <br />in formation presented hereon is true <br />and correct to the best of my <br />knowledge and in or ion. <br />a <br />Date Micha / W. Lu l , CO P.E. 26046 <br />Existing stora a capacity of water in the impoundment (from principal spillway, in acre- <br />feet). ? -