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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR 5LIIRRY IMPOIINDMENTS <br />Inspectors Name: ~~~ ~~ Date: Yy .` ,.EC" o"l <br />NPDES ID. No.:CO-0000213 Date Last Inspected:0(,~„a..o1 <br />_ Facility Configuration: Total Incised Pond <br />Site Name: Impoundment #0014 Location:47N16W SEC 31 <br />Mine Name: New Horizon Mine Location•1 mi.NW of Nucla. CO. <br />Mine ID No.: CDMG Permit #0008-B1 <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 />CIRCLfi OR WRITE IN APPROPRIATE RESPONSE <br />Foundation preparation (removal of vegetation, stumps., topsoil) Y® No <br />Lift thickness (inches) <br />Compaction according to approved plan ® No <br />Burning (specify extend and location) Yea <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />Seepage (specify location, color, and approx. volume) <br />a.) From underdrain pipes: Yes No <br />b.) At isolated points oa embankmeaC slopes: Yes <br />C) At natural hillside: Yes <br />d) Over widespread areas Yes <br />e) From downsteam foundation area Yea <br />f) •eoils" beneath strain or ponded water Yes <br />Cracks or scarps on crest Yes <br />Cracks or scraps on slope Yes <br />Sloughing or bulging on slope Yes <br />Major erosion problems Yes <br />Surface movements is valley bottom or on hillside Yes <br />Erosion of tce Yes <br />Water impounded against tce Yes ~ <br />Existing emban]o4ent freeboard (feet) - ~_ <br />Cracks, bulging, or erosion oa upsteam face Yes No <br />Visible sumps or sinkholes in slurry surface Yes No <br />Clogging <br />a) Spillway channels and pipes Yes No <br />b) Decant system Yes No <br />c) Diversion Ditches Yes No <br />Cracking or crushing of pipes <br />a) Spillway pipes Yes No <br />b) Decant system Yes No <br />Trash racks clear and in <br />N/A <br />N/A <br />N/A <br /> <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 /> <br />N/ <br />N/ <br />~a <br />~O N~ <br />F:\Eng\DATA\NP\pond-banks\DAMFOR <br />~ ,q JJ b ! <br />