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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Dennis Jones DATE <br />NPDES I D <br />10/17/89 <br />. NO.. <br />FACILITY CONFIG - <br />Incised Pond <br />DATE LAST <br />INSPECTION: 8/9/89 <br />SITE NAME: Wad a Im oundment #002 LOCATION: N~/, NE'/. Sec. 34 T6N R87W <br />MINE NAME: eneca .one ea o y oa o LOCATION: mi. o ay en, <br />MINE I.D. N .. ermi - - OWNER'S R .. on cu ian, upt. <br />Circle or write in appropriate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoil): _ Yes No <br />2. Lift thickness: in. <br />3. Compaction according to approved plan: Yes No <br />4. Burning (specify extent and location): Yes No <br />5. Angle of slope: upstream, downstream Total = _ N/A <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain oipes: Yes No N/ <br /> At isolated points on em an ment s opes: Yes No <br /> At natural hillside: Yes ® N/A <br /> Over widespread areas: Yes ® N <br /> From downstream foundation area: Yes tJo <br /> "Boils" beneath stream or ponded wa er: Yes ® N/A <br />7. Cracks or scarps on crest: Yes No <br />8. Cracks or scarps on slope: Yes No <br />9. Sloughing or bulging on slope: Yes No <br />10. *Major erosion problems: Yes N~ N/A <br />11. Surface movements in valley bottom or on hillside: Yes !J N/A <br />12. *Erosion of toe: Yes No N/A <br />13. *Water impounded agaanst toe: Yes No N/A <br />14. Existing embankment freeboard: N/A fee t <br />15. Increase x Decrease in water ]evel: 1 feet <br />16. Cracks, bulging, or erosion on upstream face: Yes No N/A <br />17. Visible sumps or sinkholes in slurry surface: Yes No N/A <br />18. *Clogging <br /> Spillway channels and pipes: Yes N~ N/A <br /> Decant system: Yes No ~1A~ <br /> Diversion ditches: Yes N~ N/A <br />19. *Cracking or crushing of pipes <br /> Spillway pipes: Yes Pro /A <br /> Decant system: Yes No 'A <br />20. Trash racks clear and in place: Ye Wo N/A <br />~4ajor adverse changes in these items could cause instability and should be reported to <br />the Engineering Manager and Mine Superintendent far further evaluation. Adverse condi- <br />tions noted in these items should normally be described (extent, location, volume, etc.) <br />in the space on the back of this sheet. <br />