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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />W_ -- <br />Inspector's Name: 4, fz <br />Pond ID No.: 1211 -CO- -03836-06 <br />Facility Configuration: VII <br />Site Name: 6MN MINE WATER RESV. <br />Mine Name: FOIDEL CREEK MINE <br />Mine ID No.: 05-03836 <br />Date: �G�,&�,er <br />Field Hazard Classificatfon (FMC): <br />Date of Last Inspection: IVAV�D 7 <br />Location: 25 MILES SW tF <br />Location: STEAMBOAT SPRINGS, CO <br />Owner's Rep.: JERRY NETTLETON <br />Circle or write in appropriate response <br />6. 'Seepage (specify location, color, and approximate volume) <br />11. <br />12 <br />13. <br />14. <br />15. <br />16. <br />Surface movements in valley bottom or on hillside <br />'Erosion of toe <br />`Water impounded against toe <br />Existing embankment freeboard (feet) <br />Increase Decrease in water level (feet) <br />Cracks, bulging, or erosion on upstream face <br />Yes �!N <br />Y sNo <br />Yes No <br />` %—Feet <br />Feet <br />1—Yes_k/No <br />From underdrain pipes <br />Yes <br />No <br />0 <br />A. <br />lNA? <br />At isolated points on embankment slope <br />Yes.&O <br />18. <br />'Clogging <br />At natural hillside <br />Yesl <br />No <br />Spillway channels and pipes <br />Yes_No <br />Over widespread areas <br />Yes ' <br />No <br />Decant system <br />Yes No <br />From downstream foundation area <br />Yes <br />Diversion ditches <br />Yes No <br />"Boils" beneath stream or ponded water <br />Yes <br />No <br />19 <br />'Cracking or crushing of pipes <br />7. Cracks or scarps on crest <br />Yes <br />eNO <br />Spillway pipes <br />Yes o <br />B. Cracks or scarps on slope <br />Yes <br />No <br />Decant system <br />_Yes No <br />9. Sloughing or bulging on slope <br />Yes <br />20. <br />Trash racks clear and in place w4laof1—Yes <br />No <br />10 'Major erosion problems <br />Yes <br />No <br />" Major adverse changes in these items could cause instability and should be reported to the District Manager for further evaluation Adverse <br />conditions noted in these items should normally be described (extent, location, volume, etc ) in the space below and on the back of this sheet <br />Inspection Category Comments <br />STAFF GAUGE <br />WSEL <br />14 FREEBOARD FROM INVERT OF EMERGENCY SPILLWAY <br />44 A <br />,r <br />4 + r <br />REFERENCE ELEVATION DATA <br />Y Or/ 1.0' on Staff Gauge= 6713 00 <br />Emergency Spillway = 6714.90 <br />Top of Embankment = 6717.00 <br />/' <br />