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<br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: ~1 ._ts ~~„~,~ Date: ~~- 0 6- 06 <br />NPDES ID. No.:CO-0000213 Date Last Inspected: ~ct- I¢-a~ <br />Facil ity 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 />Owners Rep.: R. L. Wade. Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIAT$ RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) ~ No N/A <br />2. Lift thickneae (inches) <br />3. Compaction according to approved plan ~ No N/A <br />4. Burning (specify extend and location) Yea ~ N/A <br />5. Angle of elope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) Fran uaderdrain pipes: Yes ~ N/A <br /> b.) At isolated points on embaNcaeat slopes- Yes ® N/A <br /> c) At natural hillside: Yes ~ N/A <br /> d) OYei widespread azeas Yes ® N/A <br /> e) Fran dowasteam foundation area Yes ~ N/A <br /> f) 'soils' beneath atram or ponded water Yea ~ N/A <br />7. Craoks or scarps on crest Yea ® N/A <br />8. Cracks or scraps on slope Yea ~ N/A <br />9. Sloughing or bulging on elope Yes ® N/A <br />10. Major erosion problems Yes @ N/A <br />11. Surface movements is valley bottas or on hillside Yes ® N/A <br />12, firosion of tce Yes N®+ N/A <br />13. Water impounded against toe Yes <br />~ 4no N(A <br />14. 8xisting embankment freeboard (feet) _ <br />I <br />~ Feet <br />15. Cracks, bulging, or erosion on upsteam face Yea lNyl N/A <br />16. Visible sumps or sinkholes in slurry surface Yea ®N N/A <br />17, Clogging <br /> a) Spillway channels and pipes Yes ~ N/A <br /> b) Decant system Yea rNg N(A <br /> c) Divereioa Ditches Yes ti[x9 N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes N/A <br /> b) Decant system Yes ~ <br />N N/A <br />19. Trash racks Clear and in place No N/A <br />~Onld 15 Y10~ ~~ScXncrClil'L~ <br />~ -/ <br />F:\Eng\DATA\WF\pond-banks\DAMFORM.wpd <br />r <br />IZ aG_o <br />