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<br />PERIODIC INSPECTION FORM <br />FIII,TER, SIDIMQPT, OR SLURRY <br />Inspectors Name : 1Z , L , ~~~ Date : 9 - 1 s - Rl <br />NPDES ID. No.:CO-0000213 004 Date Last Inspected: -7.Z3.g"t <br />Facility Configuration:Side Hill Pond <br />Site Name: Im~loundment #004 Location:47N16W36CB <br />Mine Name: New Horizon Mine Location:2 [rL.NW of Nucla CO. <br />Mine ID No.: CMrRn Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (rertuval of vegetation, sturtq~s., topsoil) ® No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan ~ No N/A <br />4. Burning (specify extend and location) Yes ® N/A <br />5. Angle of slope: 3~1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) From underdra in pipes: Yes ~ N/A <br /> b.) At isolated points on embankment slopes: Yes No N/A <br /> c) At natural hillside: Yes ® N/A <br /> d) Over widespread areas Yes ~ N/A <br /> e) From downstream foundation area Yes ~ N/A <br /> f) "Boils" beneath scream or ponded water Yes N/A <br />7. Cracks or scarps on crest Yes ® N/A <br />e. 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 nn hillside Yes ~ N/A <br />12. Erosion Of tce Yes ~ N/A <br />13. Water impounded against tce Yes i 0° N/A <br />19. Existing embankment freeboard (feet) II L Feet <br />15. Cracks, bulging, or erosion on upstream 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 ,,y 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 /> <br />