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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: }~ _-- C~~,,pY.w Date: 3- 15-0 ~ <br />NPDES ID. No.:CO-0000213 009 Date Last Inspected: \2.-~Z-U3 <br />Facility Configuration:TOtal Encised Pond <br />Site Name: Impoundment #009 Location:47N16W36 <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla, CO. <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIAT E RESPONSE <br />i. Foundation Preparation (removal of vegetation, stumps., topsoil) Ye No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan Ye No N/A <br />4. Burning (specify extend and location) Yes io~ N/A <br />5. Angle of elope: 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 elopes: Yes ~ N/A <br /> c) At natural hills ids: Yes ®• N/A <br /> d) Over widespread areas Yes ® N/A <br /> e) From downsteam foundation area Yes ~ N/A <br /> f) "Boils" beneath etram or ponded water Yes ~ N/A <br />7. Cracks or scarps on crest Yes ® N/A <br />B. Cracks or scrape on elope Yes yp N/A <br />9. Sloughing or bulging on elope Yea ® N/A <br />10. Najor erosion problems _ Yes ® N/A <br />11. Surface movements is valley bottom or on hillside Yee ® N/A <br />12. Erosion of toe Yes ® N/A <br />13. Water impounded against toe Yea ~ N/A <br /> ' <br />14. Existing embankment freeboard (feet) ~ Feet <br />15. Cracks, bulging, or erosion on upateam face Yes N/A <br />16. Visible sumps or sinkholes in Blurry surface Yes ~ <br />N 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 ^ <br />l1 N/A <br />18. ~ Cracking or crushing of pipes <br /> a) Spillway pipes Yes N® N/A <br /> b) Decant system Yee ~ N/A <br />19. Trash racks clear and in place Ye No N/A <br />