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Date: <br />Time: <br />Name of Inspector: . ' <br />Current Panel Being Mined: <br />1, Weekly Inspection D Monthly Inspection <br />Notes: <br />Signature of Inspector: r r i - c <br />Monument Dam <br />Inspection Form <br />Yes No <br />❑ C4 Is mining , Within I mile of Monument Dare? <br />Are there visible surface cracks on the darn? <br />If yes, indicate length and size of crack- <br />`0 Is there evidence of subsided areas on or around dam? <br />If yes, indicate where and degree. <br />❑ <br />0 Are there bulges on the dam? <br />If yes, indicate where and degree. <br />❑ �J Are there signs of seeps 011 the dam? <br />If yes, indicate there and estimated flow. <br />Are there any other potentially damaging features on the darn <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 />} <br />Inspections are performed- hnder 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 />