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PERIODIC INSPECTION FORM <br />~' Water, Sediment, or Slurry Im7pou^n~dment~ <br />SNSPECTOR'S NAME: Dennis Jones DATE: J ' of ~ - ~ Z <br />NPDES I.D. NO.: NL ('' <br />~ <br />FACILITY CONFIGURATION: Incised Pond DATE LAST INSPECTION: _ J - <br />SITE NAME: Truck Wash Sup p lv Pond LOCATION: NNPk NEB Sec 34 T6N R87W <br />MINE NAME: Seneca Mine IZ (Seneca Coal Co) LOCATION: 7.1 mi. SE of Hayden CO <br />MINE I.D. NO.: CDMG Permi t No. C-80-005 OWNER'S REP.: Grego Kitchen Gen Mgr <br />Circle or write in aporooriate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: Y~ <br />2. Lift thickness: 12 inc hes <br />3. Compaction according to approved plan: Yes <br />4. Burning (specify extent and location): No <br />5. Angle of slope: 2:1 upstream, 2:1 downstream Total = 4:1 <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes: NSA <br /> At isolated points on embankment slopes: Yes No N/A <br /> At natural hillside: Yes No N/A <br /> Over widespread areas: Yes No N/A <br /> From downstream foundation area: Yes No N/A <br /> "Boils^ beneath stream or ponded water: Yes No N/A <br />7. Cracks or scarps on crest: Yes No N/A <br />8. Cracks or scarps on slope: Yes No N/A <br />9. Sloughing or bulging on slope: Yes No N/A <br />10. *Major erosion problems: Yes No N/A <br />11. Surface movements in valley bottom or on hillside: Yes No N/A <br />12. *Erosion of toe: Yes No N/A <br />13. *Water impounded against toe: Y <br />e <br />s N N/A <br />14. Existing embankment freeboard: (normal = 2.7') ~ <br />- <br />7 <br />a`~ feet <br />15. Increase Decrease in water level: 4~u c~c.~ feet <br />16. Cracks, bulging, or erosion on upstream face: Yes ~ N/A <br />17. Visible sumps or sinkholes in slurry surface: ~A <br />18. *Clogging <br /> Spillway channels and pipes: Yes /~So1 N/A <br /> Decant system: N A ~~~~ <br /> <br />Diversion ditches: <br />~ ` <br />!/ <br />N/A GJ/i <br />19. *Cracking or crushing of pipes / <br /> Spillway pipes: Yes ~i11 N/A <br /> Decant system: ~ ~~~ <br />20. Trash racks clear and in place: NL <br />*Major adverse changes in these items could cause instability and should be reported to the <br />Engineering Manager and Mine Superintendent for further evaluation. Adverse conditions noted in <br />these items should normally be described (extent, location, volume, etc.) in the space on the <br />back of this sheet. <br />