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PERIODIC INSPECTION FORM <br />Pater, Sedi~ent, u' Slurry Iepoundments <br />INSPECTOR'S NAME: ~p~~..~5 Jo~~ S DATE: ~'~ ~ -6 <br />N.P.D.E.S. I.D. NO.: rn-nnnn2PT n_P_ nn.a <br />FACILITY CONFIGURATION: diked Pnnd DATE LAST INSPECTION: ~ Z - ~~ - <br />SITE NAME: Nnrthwact lmnnundmPnt ilnn3 LOCATION: $E ,SW's, Sec. 27. T6N. R87W <br />MINE NAME: Sanara TT Mina (P ahoy Coal Comoanvl LOCATION: 7 1 mi SE of Havden, CO <br />MINE I.D. NO.: C.MIRR Parmit Nn. f.-0n5-Rn OWNER'S REP.: Don Zulian. Suot. <br />Circle or write in aapronriate resvonse <br />1. Foundation preparation (removal of vegetation, stumps, topsoil?) Yes No <br />2. Lift thickness (inches) 12 _ inches <br />3. Compaction according to approved plan Yes No <br />4. Burning (specify extent and 1•ocation) N/A X1CkXXR~R <br />5. Angle of Slope {deg) 9.1^mctraam_ 3c1 dnwnstre m. total = ~'~'9M'~u <br />~ <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes N/A XR%XX~ <br /> At isolated points on embankment s opes Yes <br /> At natural hillside Yes <br /> Over widespread areas Yes <br /> From downstream foundation area Yes <br /> "Boils" beneath stream or ponde water Yes <br />7. Cracks or~scarps on crest Yes <br />8. Cracks or scarps on slope Yes ~ <br />9. Sloughing or bulging on slope Yes ~ <br />10. *Major erosion problems Yes ~ <br />11. Surface movements in valley bottom or on hillside Yes <br />12. *Erosion of toe Yes <br />13. *Water impounded against toe Yes <br />14. Existing embankment freeboard (feet) ~_ feet <br />15. Increase Decrease in water level (feet) O feet <br />16. Cracks, bulging, or erosion on upstream face Yes ~o <br />17. Visible sumps or sinkholes in slurry surface N/A X8!<XXNtd <br />18. *Clogging <br /> Spillway channels and pipes Yes ~ <br /> Decant system N/A Xd~XXNd <br /> Diversion ditc es Yes <br />19. *Cracking or crushing of pipes <br /> I' - (~ <br />Spillway pipes W~~Ip.~ ~e~~.5 4VG.~V~Y h0• ide <br />Yes No <br />~ <br /> Decant system ETA XXNrM <br />20. Trash racks clear and in place N/A K~1>iXXWdj <br />*Ma,j or adverse changes in these items could cause instability and should be reported to <br />the Engineering Manager and Mine Superintendent for further evaluation. Adverse condi- <br />tions noted in these items should normally be described (extent, location, volume, etc.) <br />in the space on the back of this sheet. ' <br />