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V4~1.'e ~ ^~~ lu.~pok~.cXU.cwV- UE'~OlareS v" / <br />VPERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Ilapoundments <br />INSPErCTOR'S NAME: ~2~v.~5 J o ~.PS DATE: ~ <br />•'N.P'.D.E.S. I.D. NO.: rn_nnnn~~T n_P. ncB <br />FACILITY CONFIGURATION: ,j;rnss-Valley Pond DATE LAST <br />SITE NAME: ._ Pnnd Anna LOCATION: <br />MINE NAME: ~ CPnPCa TT Mina (Paahndy Coal ('.onTpanv) LOCATION: <br />MINE I.D. NO.: (`.MIRK Parmit Nn. r-nn~-Rn OWNER'S R <br />~~ 2 ~' g 7 <br />INSPECTION: ~i v" ~- <br />SWyNWy. Sec. 7. T5N. R88W <br />7.1 mi. SE of Havden. CO <br />~P•: Don Zulian. Suot. <br />Circle or write in appropriate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoill) Ye No <br />2. Lift thickness (inches) ~_ inches i <br />3. Compaction according to approved plan Yes No <br />4. Burning (specify extent and location) N/A YX9~(XX~9( <br />T 5. Angle Of slope-FdegreM~ 3 •1 upatraam 3 ~1 downstream. total = ¢~~'9~'' <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes _ _N/A XRRXX~ <br /> At isolated points on embankment s opes Yes <br /> At natural hillside Yes <br /> Over widespread areas Yes <br /> From downstream founds ion area Yes <br /> "Boils" beneath stream or ponde water Yes <br />7. Cracks or scarps on crest Yes inn <br />8. Cracks or scarps on slope Yes Prlo~ <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 ~o <br />13. *Water impounded against toe ~ Yes N~a <br />14. Existing embankment freeboard (feet) ~y~'~n~a~e. 3~;~~~;a~yocye+sd °F9.`~~f >8.`_ feet <br />15. ~ Increase Decrease in water level (feet) t~4s ~4~_ _ feet <br />16. Cracks, bulging, or erosion on upstream face Yes <br />17. Visible sunps or sinkholes in slurry surface N/A ~5(XX1U <br />18. *Clogging <br /> Spillway channels and pipes Yes <br /> Decant system N/A ~Y~Q(XJNa( <br /> Diversion ditc es N/A JY~+CXNitX <br />19. *Cracking or crushing of pipes <br /> Spillway pipes Yes I~n7 <br /> Decant system N )0'X9bYXNin( <br />20. Trash racks clear and in place ~'No <br />*Major 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 />