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Date: ttgr 7/1 �- <br />Time: <br />/f Name of of Inspector: e �'-- <br />Current Panel Being Mined: t. <br />'Weekly Inspection ❑ Monthly Inspection <br />Yes <br />No <br />Is mining within 1 mile of Monument Dam? <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 />O Are there bulges on the clam? <br />Are there signs of seeps on the dam? <br />If _yes, indicate where and estimated tlox, . <br />C7 <br />Monument Dam <br />Inspection Form <br />If yes, indicate where and degree. <br />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: �1 =L( L r « 0 - ) A r 1;12 CO C'rfe, � U L- w <br />Signature of Inspector: C `t�� �— f7 <br />Iiispections are performed i.ncler 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 />