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PERIObIC INSPECTION FORM <br /> 4~.TER, SIDIB~]T, OR SLURRY II+IPOUIaA~NTS <br />Inspectors Name : ~~ C~..blc~ Date : ~ . Z- Qfj <br />NPDES ID. No.:CC~-0000213 004 Date Last Inspected: J/ .~9,q~ <br />Facility Configuration:Side Hill Pond <br />Site Name: Impoundment #004 Location:4 7N16W36CB <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nu cla. CO. <br /> <br />Mine ID No.: Q~RD Permit #0008-81 <br />Owners Rep.: R L Wade Mine Marla~er <br /> CIRCLE OR WRITE IN APPROPRIATE R ESPONSE <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 ® N/A <br />5. Fvigle of slope: 3:1 upstream, 3~1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) From underdra in pipes: Yes ~ N/A <br /> b.) At isolated points on embanlanent slopes: Yes ® N/A <br /> c) At natural hillside: Yes ® N/A <br /> d) Over widespread areas Yes Qa N/A <br /> e) From downstream foundation area Yes ~cj N/A <br /> f) "Boils" beneath scream or ponded water Yes (~ N/A <br />7. Cracks or scalps on crest Yes ® N/A <br />8. Cracks or scraps on slope Yes 7(1~ N/A <br />9. Sloughing or bulging on slope Yes ~ N/A <br />10. Major erosion problems Yes N/A <br />11. Surface movements in valley bottom or on hillside Yes ~ N/A <br />12. Erosion of tce Yes ® N/A <br />13. Water impounded against toe Yes I ® N/A <br />14. F>cisting embankment freeboard (feet) /~ t Feet <br />15. Cracks, bulging, or erosion on upstream 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) Diversion Ditches Yes ~ N/A <br />18. Clacking or crushing of pipes <br /> a) Spillway pipes Yes ~ N/A <br /> b) Decant system Yes ® N/A <br />19. 'Nash racks clear and in place Ye No N/A <br />~GC.c O~ (/o ~"~/ ~.~ Gut~w~ PPpO REG~S,T <br />p .~EWISG;.,E,9 <br />0.~5 G••m <br />n:_ ~•.o <br />9~. •!/ <br />~SS~ONAI. <br />y~--~~~s <br />