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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: I.( -evor Rdd�a l� <br />NPDES ID. No.:CO- 0000213 <br />Date. �� ��;� ✓. ��� <br />Date Last Inspected: .4y M3 <br />Facility Configuration: Parcel Incised P <br />Pond <br />Site N <br />Name: Impoundment #011 Location:46N16W SEC 1 <br />1 <br />Mine N <br />Name: New Horizon Mine Location:l mi.NW of N <br />Nucla, C <br />CO. <br />Mine I <br />ID No.: CDMG Permit 40008 -81 <br />Owners R <br />Rep.: Rick Wolney, Mine Manager <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. F <br />Foundation Preparation (removal of vegetation, stumps., topsoil) N <br />No N <br />N/A <br />2. L <br />Lift thickness (inches) <br />3. C <br />Compaction according to approved plan D <br />D N <br />No N <br />N/A <br />4. B <br />Burning (specify extend and location) Y <br />Yes N <br />No N <br />N/A <br />5. A <br />Angle of slope: 3 :1 upstream, 3:1 downstream <br />6. S <br />Seepage (specify location, color, and approx. volume) <br />a.) From underdrain pipes: Y <br />Yes 0 <br />0 N <br />N/A <br />b.) At isolated points on embankment slopes: Y <br />Yes N <br />N N <br />N/A <br />c) At natural hillside: Y <br />Yes N <br />N/A <br />d) Over widespread areas Y <br />Yes I <br />Io N <br />N/A <br />e) From downsteam foundation area Y <br />Yes N <br />No N <br />N/A <br />f) "Boils" beneath stream or ponded water Y <br />Yes N <br />N N <br />N/A <br />7. C <br />Cracks or scarps on crest Y <br />Yes N <br />No N <br />N/A <br />8. C <br />Cracks or scraps on slope Y <br />Yes N <br />N/A <br />9. S <br />Sloughing or bulging on slope Y <br />Yes N <br />N N <br />N/A <br />10. M <br />Major erosion problems Y <br />Yes 0 <br />N/A <br />11. S <br />Surface movements in valley bottom or on hillside Y <br />Yes N <br />0'� N <br />N/A <br />12. E <br />Erosion of toe Y <br />Yes & <br />&) N <br />N/A <br />13. W <br />Water impounded against toe <br />Y <br />Feet <br />14. E <br />Existing embankment freeboard (feet) ( <br />1. F <br />15. C <br />Cracks, bulging, or erosion on upsteam face Y <br />Yes o <br />o N <br />N/A <br />16. V <br />Visible sumps or sinkholes in slurry surface " <br />"Yes N <br />N/A <br />17. C <br />Clogging <br />a) Spillway channels and pipes Y <br />Yes N <br />No N <br />N/A <br />b) Decant system Y <br />Yes N <br />N N <br />N/A <br />C) Diversion Ditches Y <br />Yes N <br />N/A <br />18. C <br />Cracking or crushing of pipes <br />a) Spillway pipes Y <br />Yes N <br />No N <br />N/A <br />b) Decant system Y <br />Yes o <br />o N <br />N/A <br />1,l9�. � <br />racks clear and in p <br />Ye N <br />No N <br />N /A <br />�!Trasht r <br />]_ Y <br />} <br />G <br />v ° o <br />P�� u <br />uv'� cQ;Sc�►�cry.z - <br />- lu4— I b—, v <br />