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<br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: }~gLS G.,,bY,p, Date: 6 _2..x- W <br />NPDES ID. No.:CO-0000213 005 Date Last Inspected: 3-ip-oo <br />Facility C onfiguration:Side Hill Pond <br />Site Name: Impoundment #005 Location:57N16W36AD <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla. CO. <br />Mine ID No.: CMLRD Permit #0006-B1 <br />Owners Rep.: R. L. Wade, Mine Manager <br />CIRCLE OR WRITE IN APPROPRIAT E RESPONSE <br /> <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) ~ No <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan Ye No <br />9. Burning (specify extend and location) 'f es <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br />7 <br />8. <br />9. <br />10 <br />11 <br />12 <br />13 <br />19 <br />15 <br />16 <br />17 <br />18 <br />1~ <br />a.) From underd rain pipes: 'i es <br />b.) At isolated points on emban kment slopes: Yes <br />c) At natural hillside: 1'es +o <br />d) Over widespread areas Yes <br />el From downsteam foundation area 'Yes <br />fI "Boils" beneath stram or ponded water Yes ~hrgl <br />Cracks or scarps on cresc Yes ~y <br />Cracks or scraps on slope Yes f~7 <br />Sloughing or bulging on slope Yes <br />Ma]or erosron problems Yes <br />Surface movements rn valley bottom or on hillside Yes (f~l <br />Erosion of COe Yes V' <br />Water rmpounded against toe Ye <br />s ~~ V9o <br />Eaistr nq embankment freeboard (feet) 11 <br />'' ; <br />Cracks, bulging, or erosion on upsteam face Yes <br />Visible sumps or sinkholes in slurry surface Yes <br />Clogging <br />a) Spillway channels and pipes Yes <br />bl Decant system Yes <br />c) Diversron Ditches 1'es <br />Cracking or crushing of pipes <br />a) Spillway pipes Yes <br />b) Decant <br />Trash raels ele <br /> <br />c:\data\wpdata\damform <br />N/A <br />N/A <br />N/A <br />N/a <br />N/A <br />NiA <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />IJ/A <br />N/A <br />N/A <br />N/A <br />N/a <br />FeeC <br />N/A <br />N/A <br />® N/A <br />® N/A <br />I~ tJ/A <br />® N/A <br />N IJ/A <br />No N/A <br />G -~-~ _ °~ <br />