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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: 1`._~c G,.,,~C~ Date:___ r 1•S' Qq <br />NPDES ID. No.:CO-0000213 009 Date Last Inspected: ~,_~~_q0i <br />Facil ity Configuration:Side Hill Pond <br />Site Name: Impoundment #009 Location:9 7N16W36CB <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla. CO. <br /> <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owner s Rep.: R. L. Wade. Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE R ESPONSE <br />1. Foundation Preparation (removal of vegetation, slumps., tops oil) ~ Po N/A <br />2. Lift thicY.ness (inches) <br />3. Compaction according to approved plan ~ No N/A <br />4. Burning (specify extend and location) Yes ~ IJ/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) Fiom underdialn pipes: Yes ~ N/A <br /> b.) At isolated points on emban Y.ment Slopes: Yes ® N/A <br /> c) At natural hillside: Yes ~ N/A <br /> d) Over widespread areas Yes ® N/A <br /> e) FLOm downsteam foundation area Yes ~ N/A <br /> f) "Boils" beneath steam or ponded water Yes ® N/A <br />7, Ciac ks or scarps on crest Yes ® N/A <br />8. 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 ~ iJ/A <br />12. Erosion of toe Yes ® N/A <br />13. water impounded against toe Yes ~,® N/A <br />19. Existing embankment freeboard (feet) ~~ L 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 Yes ~ N/A <br /> b) Decant system Yes ® N/A <br /> c) Diversion Ditches Yes ® N/A <br />1B. Cracking or crushing of pipes <br /> a) Spillway pipes Yes ® N/A <br /> b) Decant System Yes ~ N/A <br />19. Trash racks clear and in place ~ No N/A <br />Toc~ O ~ 4)e~+r i ~ ~i~or . <br />c: \data\wpdata\damform.doc <br />9~ 9- 9~ <br />