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S <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Namea~~~~, G,b~-•.. Date: !D ~ o't <br />NPDES ID. No.:CO-0000213 Date Last Inspected: o,3_)Z- o"( <br />Facility Configuration: Total Incised Pond <br />Site Name: Impoundment #008 Location:46N15W SEC 6 <br />Mine Name: New Horizon Mine Location:l mi.NW of Nucla. CO. <br />Mine ID No.: CDMG Permit #0008-81 <br />Owners Rep.: R. L. Wade. Mine Manager <br />CIRCLE OR WRITE IN APPROPRIAT$ RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) es No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan ~, No N/A <br />4. Burning (specify extend and lxatioa) Yea ~ N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) Frds underdraia pipes: Yes ® N/A <br /> b.) At isolated points on embanloneat slopes: Yes ~ N/A <br /> c) At natural hillside: Yes ~ N/A <br /> d) Over widespread areas Yes ~ N/A <br /> e) From downsteam foundation area Yes ® N/A <br /> f) •BOils• beneath scram oz goaded water Yee d~ N/A <br />7. Cracks or scarps on crest ~ Yes (yFl ~ N/A <br />e. Cracks or scraps on slope Yea ® N/A <br />9. Sloughing or bulging on elope Yes ® N(A <br />10. Maj Or erosion problems Yes ® N/A <br />11. Surface movements is valley bottom or on hillside Yes ~. N/A <br />12. Erosion of tce Yes ~ N/A <br />13. Hater impounded against tce Yes Q7rn N/A <br />14. Exist iag embanlonent freeboard (feet) ~] Feet <br />15. Cracks, bulging, or erosion on upsteam face Yee ® N/A <br />16. Visible sumps or sinkholes is slurry surface Yes ~jI N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yes ® N/A <br /> b) Decant system Yes ® N/A <br /> c) Diversion Ditches Yes ® NIA <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yee Q7~ N/A <br /> b) Decant system Yes CND N/A <br />19. Trash racks clear and in place ~ No N/A <br />~O rC1 ~ S t10'F' ~~Sc~Or e~ ~tiq__ <br />F:\Eng\DATA\NP\pond-banks\DAMFORM.wpd <br />G ~r~-a-1 <br />