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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Dennis Jones DATE: 11/15/88 <br />NPDES I.D. NO.: - <br />FACILITY CONFIG : Incised Pond DATE LAST INSPECTION: 8/9/88 <br />SITE NAME: Wad a Im oundment #002 LOCATION: NW'/~ NEY~ Sec. 34 T6N R87W <br />MINE NAME: eneca ine ea o y oa o LOCATION: m~. o ay en, <br />MINE I.D. N .: erm~t - - OWNER'S R .. on u ian, upt. <br />Circle or write in appropriate response <br />1, Foundation preparation (removal of vegetation, stumps, topsoil): _ <br />2. Lift thickness: <br />3. Compaction according to approved plan: <br />4. Burning (specify extent and location): <br />5. Angle of slope: upstream, downstream <br />6. *Seepage (specify location, color, and approximate volume) <br />~- _ From underdrain pipes: <br />At isolated points on em an ment s open: <br />At natural hillside: <br />Over widespread areas: <br />From downstream foundation area: <br />"Boils" beneath stream or ponded wa er: <br />Yes <br />Yes <br />Yes <br />Tota] _ <br />No <br />in. <br />No N/ <br />No <br />N/A <br />Yes No N/ <br />Yes No <br />Yes ® N/A <br />Yes <br />Yes No N <br />Yes ® N/A <br />7, Cracks or scarps on crest: Yes No /A <br />8. Cracks or scarps on slope: Yes No N A <br />9. Sloughing or bulging on slope: Yes No /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 No N/A <br />13. *Water impounded against toe: Yes No N A <br />14. Existing embankment freeboard: N/A fee t <br />15. Increase X Decrease in water level: 2.5 fee t <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. *Clo99in9 . <br /> Spillway channels and pipes: Yes ~ N/A <br /> Decant system: Yes o ~~ <br /> Diversion ditches: Yes ® N/A <br />19. *Cracking or crushing of pipes <br /> Spillway pipes: Yes No N A <br /> Decant system: Yes No A <br />20. Trash racks clear and in place: Yes No /A <br />~4ajor adverse chanoes in these items could cause instability and should be reported to <br />the Engineering Manager and Mine Superintendent for 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 />