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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name:~is ~~,~~ Date: 03- ~~-oS <br />NPDES ID. No.:CO-0000213 Date Last Inspected :IZ- a7- O~- <br />Facility Configuration: Total Incised Pond <br />Site Name: Impoundment #009 Location:47N16W SEC 36 <br />Mine Name: New Horizon Mine Location:l mi.NW of Nucla, CO. <br />Mine ID No.: CDMG Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE R ESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., tops oil) Yes No N/A <br />2. Lift thickness (inches) ~7 / N~ <br /> <br />3. r <br />Compaction according to approved plan <br />Ye <br />No <br />N/A <br />4. Burning (specify extend and location) Yes No N/A <br />S. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> <br />a.) From underdrain pipes: <br />Yes ~~~ <br />1:5+" <br />N/A <br /> b.) At isolated points on embankment slopes: Yea NO N/A <br /> c) At natural hillside: Yea NO N/A <br /> d) Over widespread areas Yes ~ N/A <br /> e) From downsteam foundation area Yea ~ N/A <br /> f) "Boils" beneath atram or ponded water Yes Q N/A <br />7. Cracks or scarps on treat Yes ® N/A <br />8. Cracks or scraps on slope Yes N~ N/A <br />9. Sloughing or bulging on slope Yes N® N/A <br />10. Major erosion problems Yea ® 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 Yes ( ~ N/A <br />14. Existing embankment freeboard (feet) ~ _ Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes ® N/A <br />16. visible sumps or sinkholes in slurry surface Yes ® N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yea No N/A <br /> b) Decant system Yes ( <br />~ N/A <br /> c) Diversion Ditches Yes ^ <br />~yw~ N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes ~ N/A <br /> b) Decant system Yea '~7o N/A <br />19. Trash racks clear and in place Ye No N/A <br />F:\Eng\DATA\WP\pond-banks\DAMFORM.wpd <br />