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Monument Dam <br />Inspection Form <br />Date: < 1 t <br />r <br />Time: <br />Name of Inspector: S o� <br />Current Panel Being Mined: y - o K C <br />❑ Weekly Inspection I , Monthly Inspection <br />Yes No <br />❑ C Is mining within 1 mile of Monument Dam? <br />❑ K <br />❑ /f <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 />El <br />�- ❑ <br />1 <br />❑ <br />1 �p <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 />Are there any other potentially damaging features on the dam? <br />If yes, describe. <br />❑ t y 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 <br />Signature of Inspector: <br />Inspections are performed u er th arecti o 1 ichael J Peacock, P.E. <br />-If cracks or other potentially damaging features occur, notify Ryan Sweetwood or <br />Wendell Koontz immediately. <br />