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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name : 1~,~5 ~,~(,g Date : z.. i.. s .. fr of <br />NPDES ID. No.:CO-0000213 Date Last Inspected:~y,,,~ o~ <br />Facility Configuration: Total Incised Pond <br />Site Name: ~oundment #008 <br />Mine Name: New Horizon Mine <br />Location:46N15W SEC 6 <br />Location:l mi.NW of Nucla, CO. <br />Mine ID No.: CDMG Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manager <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />8. <br />9. <br />10. <br />11. <br />12. <br />13. <br />14. <br />15. <br />16. <br />17. <br />18 <br />19 <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />Fouadatio¢ Preparation (removal of vegetatio¢, sups., topsoil) Ye No <br />Lift thickness (inches} <br />Compaction according to approved plan ® No <br />Burni¢g (specify exte¢d and location) Yes <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />Seepage (specify location, color, and approx. volume) <br />a.) From vnderdraia pipes: Yes Q <br />b.) At isolated points on embankment slopes: Yes <br />c) AC natural hillside: ~ Yes ~fI <br />d) over widespread areas Yes ~ <br />e) From downsteam foundation area Yes <br />f) •BOils• beneath strain or podded water Yes <br />Cracks or scarps o¢ Crest - Yes Q <br />Cracks or scraps on slope - Yes <br />Sloughing or bulging oa elope Yes <br />Major erosion problems Yes <br />Surface movements Sa valley bottom or on hillside Yes <br />Erosion of toe Yes ~: <br />Hater impounded against tce Ye~ <br />Sxietiag embankment freeboard (feet) <br />Cracks, bulging, or erosion on upsteam face Yes <br />Visible sumps or sidcholes in slurry surface Yes <br />Clogging <br />a) Spillway channels and pipes Yes N~ <br />b) Decant system Yes <br />c) Diversion Ditches Yes <br />Cracking or cxvshing of pipes <br />a) Spillway pipes Yes <br />b) Decant system Yes <br />Trash racks clear sad in <br />TeF~ ~S 1'1~ ~~SG <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />Feet <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />~D~'_ <br />~J <br />~' <br />F:\Eng\DATA\HP\pond-banks\DAMFOR <br />