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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: jZ,~ ~„`~,~ Date: 3-Z4-7y o( <br />NPDE S ID. No.:CO-0000213 002 Date Last Inspected: (z -?J-2o~o <br />Faci lity Configuration:Side Hill Pond <br />Site Name: Impoundment H002 Location: 97N15W31C8 <br />Mine Name: New Horizon Mine Location: 2 mi.NW o f Nucla. CO. <br /> <br />Mine ID No.: CMLRD 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) ~ No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan ~ No N/A <br />4. Burning (specify extend and location) Yes No N/A <br />5. Angle of slope: 3:1 upstream, 3:1 dovnst ream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) From uncle rd rain pipes: Yes Q N/A <br /> b.) AC rsolated points on embankment slopes: Yes ®l N/A <br /> C) At na tu[al hills ide: Yes ~ N/A <br /> d) Over witlesp[eatl areas Yes ® N;A <br /> e) From downsteam fou nda[ron a[ea Yes ~ N/A <br /> f) "BOrls" beneath s[ram or pondetl eater Yes ~ N/A <br />7. Ctacks or scarps on crest Yes ~ N/A <br />8. Cracks or scraps on slope Yes ~ N/A <br />9. Sloughing or bulging on slope Yes ~ N/A <br />10. Major erosion problems Yes ®o N/A <br />11. Surface movements in valley bottom or on hillside Yes ® N/A <br />12. Erosion of toe Yes ~o N/A <br />13. Water impounded against toe Yes ~ <br />1 N/A <br />19. Existing embankment freeboard Ifeetl ~ Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes ® N/A <br />16. Visible sumps or sinkholes in slurry surface Yes ~o N/A <br />17. Clogging <br /> al Spillway channels and pipes Yes ~ N/A <br /> bl Decant system Yes ©o N/A <br /> C) Diversion Di[Ch es Yes ~ N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes ~ N/A <br /> b) Decant system Yes ® N/A <br />19. Trash racks clear and in pl No N/A <br /> <br />c:\data\wpdata \damform.doc <br />~-z9-2~1 <br />