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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: ~~c~ G,bk~ Date: ~_Z~_zg,~ <br />NPDES ID. No.:CO-0000213 004 Date Last Inspected:, Z 9_Za,/ <br />Facility Configuration:Side Hill Pond <br />Site Name: Impoundment #009 Location:47N16W36CB <br />Mine Name: New Horizon Mine Location:2 mi .NW of Nu cla, CO. <br /> <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owne rs Rep.: R. L. Wade. Mine Manaoer <br /> CIRCLE OR WRITE IN APPROPRIATE RESP ONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) ~Y, a No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan ~e No N/A <br />4. Burning (specify extend and location) Yes ® N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. vo lame) <br /> <br />a.) From underdrain pipes: <br />Yes ^ <br />[~' <br />N/A <br /> h.l At isolated points on embankment slopes: _ Yes ,loo N/A <br /> c~ Af natural hillside: Yes ® N/A <br /> d) Over widespread areas _ Yes ~ N/A <br /> el From downs[?ani foun da[ion ar?a '(es ~ N/t. <br /> fl "Boils" beneath stram or ponded water Yes ~ N/A <br />7. C[a Cks of scarps on Crest Yes 1@ N/A <br />B. Crac kS o[ scraps on Slope Yes ~ N/A <br />9. Sloughing or bulging on slope Yes ~ N/A <br />10. Hajor erosion problems Yes ~ N/A <br />11. Surface movements in valley bottom or on hillside Yes ® N/A <br />12. Erosion of toe Yes ® N/A <br />13. Ga[er Impounded against [Oe Yes qty <br />/, N/A <br />14. Existing embankment freeboard (feet) ~ ' y Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes ~ N/A <br />16. Visible sumps or sinkholes in slurry surface Yes No 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 ® N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes ~N N/A <br /> b) Decant Sys Yes ~ N/A <br />19. Stash racks clew[ i1`~ No N/A <br />~Onpl ~f ~~ <br />c:\data\wpdata\damfotm.doi <br />~_~,_Z~\ <br />