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Monument Dam <br />Inspection Form <br />Date: 0 <br />Time: <br />Name of Inspector: t c <br />Current Panel Being Mined: 6 " ; - (/ 7 <br />❑ Weekly Inspection,, -Monthly Inspection <br />Yes No <br />❑ >, Is mining within I mile of Monument Dam? <br />❑ 0 Are there visible surface cracks on the dam? <br />If yes, indicate length and size of crack. r t <br />n Is there evidence of subsided areas on or around dam? <br />If yes, indicate where and degree. _ r `Li <br />❑ L." Are there bulges on the dam? <br />If yes, indicate where and degree. <br />o J Are there signs of seeps on the dam? <br />If yes, indicate where and estimated flow ' 1 ) <br />-1 r 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. A <br />Notes: <br />Signature of Inspector: <br />Inspections are performe <br />• under th t' rection of Michael J. Peacock, P.E. <br />-If cracks or other potentially damaging features occur, notify Robin Schiro or Wendell <br />Koontz immediately. <br />