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f <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name : ~os ~ GJ.~'"-~. Date : l~- O\ - 6 S <br />NPDES ID. No.:CO-0000213 Date La st Inspected :pq- Z2 -OS <br />Facility Configuration: Total Incised Pond <br />Site Name: Impoundment #009 Location:47N16W SEC 36 <br />Mine Name: New Horizon Mine Location:l mi.NW of Nucla, CO. <br /> <br />Mine ID No.: CDMG Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) Ye No N/A <br />2. Lift thickness (inches) ~ Z ~ Nc~ <br />3. Compaction according to approved plan Ye No N(A <br />4. Burning (specify extend and location) 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.) From underdrain pipes: Yes ~ N/A <br /> b.) At isolated points on embankment slopes: Yea ® N/A <br /> c) At natural hillside: Yes ® N/A <br /> d) Over widespread areas Yes ~ N/A <br /> e) FYOm dOWnstedm fOUnddt ion died Yea ~ N/A <br /> f) "Boils" beneath straw or ponded water Yes ® N/A <br />7. Cracks or scarps on crest Yea ~ N/A <br />8. Clacks or scraps On slope Ye8 r~ <br />r <br />~y N/A <br />9. Sloughing or bulging on elope Yes ® N/A <br />10. Major erosion problems Yee ~ 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. Water impounded against Coe Yes ~ ® N/A <br />14. Existing embankment freeboard (feet) ~ _ Fee[ <br />15. Cracks, bulging, Or elOSion On upsteam face Yes ~ N(A <br />16. Visible sumps or sinkholes in slurry surface Yes ® N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yes ~ N/A <br /> b) Decant system Yes ~ N/A <br /> C) D1VCISlOn Ditches Yes ® N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yea ~ N/A <br /> b) Decant system Yes ~ N/A <br />19. Trash racks clear and in place ~ No N/A <br />Pond ~ S Dr~ <br />F:\Eng\DATA\WP\pond-banks\DAMFORM.wpd <br />Il- a ~' 09 <br />