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Date: 2/A-C i 2 - <br />Time: o,72 d r+ <br />Name of Inspector: -1 ii'v 7 <br />Current Panel Being Mined: 4- 3 <br />Weekly Inspection O Monthly Inspection <br />Monument Dam <br />Inspection Form <br />Yes No <br />o �( Is mining within 1 mile of Monument Dam? <br />O �( Are there visible surface cracks on the dam? <br />If yes, indicate length and size of crack. <br />O Is there evidence of subsided areas on or around dam? <br />If yes, indicate where and degree. <br />o 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 />O ) 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: otc C vr. tutTN s vw - ti ,v <br />G�o 0.,u) ..c-7(1e- <br />) <br />Signature of Inspector: <br />Inspections are perform under the direction of Michael J. Peacock, P.E. <br />-If cracks or other potentially damaging features occur, notify Robin Schiro or Wendell <br />Koontz immediately. <br />