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PERIODIC INSPECTION FORM <br />V~-TEFt, SEDII~taP, OR SLURRY INN~OUNDMENTS <br />Inspectors Name :Z~ ~~~,~ Date : CJ, ~o_ rjq <br />NPDES ID. No.:CO-0000213 005 Date Last Inspected: /_ii_g~' <br />Facility Configuration:Side Hill Pond <br />Site Name: I~g~ounc3nent #005 Location:47N16W36AD <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla, C1~. <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owners Rep.: <br /> CIRCLE OR WRITE INAPPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stuns., topsoil) ~ No N/A <br />2. Lift thickness (inches) <br />3. ConQaction according to approved plan ~e No N/A <br />4. Burning (specify extend and location) Yes ®E N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) Fran underdrain pipes: Yes ~c N/A <br /> b.) At isolated points on embanknent slopes: Yes TCf9~' N/A <br /> c) At natural hillside: Yes ~ N/A <br /> d) Over widespread areas Yes ~l N/A <br /> e) From downstream foundation area Yes ® N/A <br /> t) "Boils" beneath scream or ponded water Yes ~ N/A <br />7. Cracks or scarps on crest Yes ~ N/A <br />8. Cracks or scraps on slope Yes ~1 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 tce Yes ~ N/A <br />13. water inq~ounded against tce Yes ~ I ~ N/A <br />14. Existing embankment freeboard (feet) ~~ L Feet <br />15. Cracks, bulging, or erosion on upstream face Yes ® N/A <br />16. Visible sumps oY 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 />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yea ~ N/A <br /> b) Decant system Yes ® N/A <br />19. Trash racks clear and in place ~ No N/A <br />'F~ /// ~7 fI ~i3~Hvrge- <br />~, w e..- l <br />I YGGQ ~ v O / <br />9 <br />