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Mining Area <br />Date Inspected <br />Impoundment <br />PSC M <br />Are there arty appearances of erosion, instability, structural weakness or other <br />hazardous conditions? Vt 0 <br />if yes explain: <br />Are there any existing and required monitoring procedures and instruments? K () <br />If yes explain: <br />The depth <br />Existing storage capacity of water in the impoundment (from principal spillway, in acre- <br />feet). 1-7 1. !1 CIO-ZS -00 <br />Required storage capacity of water in the impoundment (from principal spillway, in <br />acre-feet).- 11:1.9 <br />Any other aspects of the structure affecting stability, or requiring <br />maintenance. L4 0 <br />Has structure been maintained as designed and in accordance with the approved plan <br />and the applicable regulations? <br />If no explain <br />c) RE <br />"RY <br />26046 r Y <br />0 <br />0 N A L <br />PR OFESSI ONA L E-1V GINEER 'S 5 TA TE-VE-N T <br />/ state that this mGp was prepored <br />under my supervision and a// the <br />1??formotion presentecl hereon is true <br />and correct to the best of my <br />knowledge cn(w information. <br />lic <br />(3-'l <br />V v <br />A ij??4 <br />ichoe W. Ludlo?,J CO P.E. 26046 <br />elevation of any impounded waters at the time of inspection. <br />.,, t'P ')'e-? '? k -S D . I I ki C. CA