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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name:~s5 4„~,~ Date: ~3-/¢-os <br />NPDES ID. No.:CO-0000213 Date Last Inspected:~Z-oZ - d <br />Facility Configuration: Total Incised Pond <br />Site Name: Impoundment #008 Location:46N15W SEC 6 <br />Mine Name: New Horizon Mine Location:l mi.NW of Nucla, CO. <br />Mine ID No.: CDMG Permit #0008-81 <br />Owne rs Rep.: R. L. Wade, Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE RESP ONSE <br />1. Foundation Preparation (removal of vegetation, aAtumps., topsoil) Ye No N/A <br />2. Lift thickness (inches) ~ Z i~~K <br />3. Compaction according to approved plan ~ No N/A <br />4. Burning (specify extend and location) Yes No N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) From underdrain pipes: Yes ~ N/A <br /> b.) At isolated points on embankment elopes: Yes ® N/A <br /> c) At natural hillside: Yes ~ N/A <br /> d) Over widespread areas Yea No N/A <br /> e) From downsteam foundation area Yes L~ N/A <br /> £) "Boils" beneath stram or ponded water Yes Q N/A <br />7. Cracks or scarps on crest Yea 0 N/A <br />B. Cracks or scraps on slope Yes ~ N/A <br />9. Sloughing or bulging on slope Yes ~ N/A <br />10. Major erosion problems Yes N/A <br />11. Surface movements in valley bottom or on hillside Yes N/A <br />12. Erosion of toe Yes ® N/A <br />13. Water impounded against toe Yea No N/A <br /> i <br />14. Existing embankment freeboard (feet) ~ ~ Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes ® N/A <br />16. Visible sumps or sinkhol ea in slurry surface Yes No N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yea ~ N/A <br /> b) Decant system Yes ~ N/A <br /> c) Diversion Ditches Yes ~ N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes ~ N/A <br /> b) Decant system Yea ~ N/A <br />19. Trash racks clear and in place Ye No N/A <br />F:\Eng\DATA\WP\pond-banks\DAMFORM.wpd <br />