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PERIODIC <br />SORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: ~~s Date: IZ- 06, O(n <br />NPDES ID. No.:CO-0000213 Date Last Inspected: pq -1){' -04, <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 Reg.: R. L. Wade, Mine Manager <br />1. <br />2. <br />3. <br />4. <br />S. <br />6. <br />7. <br />8. <br />9. <br />10 <br />11 <br />12 <br />13 <br />19 <br />15 <br />16 <br />17 <br />18 <br />19 <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />Foundation Preparation (removal of vegetation, stumpa.,'tOpsoil) ~ No N/A <br />Lift thickness (inches) <br />Compactio¢ according to approved pla¢ es No N/A <br />Burning (specify extend and location) Yes ~ N/A <br />A¢gle of slope: 3:1 upstream, 3:1 downstream <br />Seepage (specify location, color, and approx. valumel <br />a.} From undezdzai¢ pipes: Yes ~ N(A <br />b.} At isolated points o¢ emban)ment elopes: Yes QOM N/A <br />c} At natural hillside: Yes ~ N(A <br />d) Over widespread areas Yes ~ N/A <br />el From downsteam foundation area Yes ,~ N/A <br />f) •BOils" beneath strain or ponded water Yes ~ N/A <br />Cracks"Or aCdIpB Oa Crest Yes ~ N/A <br />Cracks Or scraps on slope - Yes ~ N/A <br />Sloughing or bulging on slope Yes ~ N/A <br />Maj oz erosion problems Yes ® N/A <br />Surface movements in valley bottom or on hillside Yes ~ N/A <br />Erosion of tce - Yes ® N/A <br />Water impounded against tce Yes _~R~ <br />- <br />r N/A <br />Existing embankment freeboard (feet) -1/ -_ <br />- <br />0. Feet <br />Cracks, bulging, or erosion on upsteam face Yea ~ NIA <br />Yislble susms or sinkholes in Slarrv surEare Yes ~ N/A <br />Clogging <br />a) Spillway channels and pipes Yes <br />b) Decant system Yea <br />c) Diversion Ditches ~ Yes <br />Cracking or crushing of pipes <br />a) Spillway pipes Yes <br />b) Decant system Yes <br />Trash racks clear and in <br /> <br />P:\Eng\DATA\WP\poad-banks\DAMFORI <br />N/A <br />Q NIA <br />N~ N/A <br />N/A <br />N/A <br />~~_ p ~o <br />