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<br />PERIODIC INSPECTION FORM <br />Pater, Sedi~ent, a Slurry Lpoundments <br />INSPECTOR'S NAME: <br />N.P.D.E.S. I.D. NO.: rn-nnnn~~l n.P. nn~ <br />FACILITY CONFIGURATION: nikad Pnnd <br />SITE NAME: ~Inrthwact Tm~undmant #0n3 <br />MINE NAME: Sanara Ti Mine (PPahndy Coal Comnanvl <br />MINE I.D. NO.: CMIRR Parmit Nn. r.-nn~-so <br />DATE: <br />DATE LAST INSPECTION: <br />LOCATION: SEaSWa. Sec. 27. T6N. R87W <br />LOCATION: 7.1 mi. SE of Hayden, CO <br />OWNER'S REP.: Don Zulian. Supt. <br />Circle or write in aoaronriate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoil?) es No <br />2. Lift thickness (inches) 1Z inches <br />3. Compaction according to approved plan Yes No <br />4. Burning (specify extent and location) N/A XR)fXXA~A <br />5. Angle Of slope {.de4*e1p.) 7rl upctraam 3~1 dnwnstr am. total = ~L b <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes X>e%XXgA <br /> At isolated points on embankment s opes Yes No <br /> At natural hillside Yes No <br /> Over widespread areas Yes No <br /> From downstream foundation area Yes No <br /> "Boils" beneath stream or ponde water Yes No <br />7. Cracks or scarps on crest Yes No <br />8. Cracks or scarps on slope Yes No <br />9. Sloughing or bulging on slope Yes No <br />10. *Major erosion problems Yes No <br />11. Surface movements in valley bottom or on hillside Yes No <br />12. *Erosion of toe Yes No <br />13. *Water impounded against toe Yes No <br />14. Existing embankment freeboard (feet) _ feet <br />15. Increase Decrease in water level (feet) _ feet <br />16. Cracks, bulging, or erosion on upstream face Yes No <br />17. Visible sumps or sinkholes in slurry surface N/A Xat%XXNiB <br />18. *Clogging <br /> Spillway channels and pipes Yes No <br /> Decant system N/A Ktl9lXXNQf <br /> Diversion ditc es Yes No <br />19. *Cracking or crushing of pipes <br /> Spillway pipes Yes No <br /> Decant system Kgi(XXNdf <br />20. Trash racks clear and in place N/A K~li(XXNdf <br />*Major adverse changes in these items could cause instability and should be reported to <br />the Engineering Manager and Mine Superintendent for further evaluation. Adverse condi- <br />tions noted in these items should normally be described (extent, location, volume, etc.) <br />in the space on the back of this sheet. <br />