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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: Zo~~ G,~(q Date: 9 -Z.~_~ <br />NPDE S ID. No.:CO-0000213 009 Date Last Inspecte d:_(~-2.1,au <br />Faci lity Configuration:Side Hill Pond <br />Site Name: Impoundment #004 Location:97N16W36CB <br />Mine Name: New Horizon Mine Location:2 mi.NW o f Nucl a. CO. <br /> <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE R ESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., tops oil) t~ No N/A <br />2. Lift thickness (inches) N /.q <br />3. Compaction according [o approved plan © No N/A <br />4. Burning (specify extend and location) Yes ® N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.I From underdrain pipes: Yes @ N/A <br /> b.) At isolated points on embankment slopes: Yes ~ N/A <br /> c) At natural hillside: Yes ® N/A <br /> d) Over widespread areas Yes ~ N/A <br /> e) From douns[eam founda[i On died Yes ~ N/A <br /> fl "Boils" beneath stram or pontled eater 1'es ® N/A <br />7. Cracks oc scarps on crest Yes ~ N/A <br />8. Cracks or scraps on slope Yes pQj 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 dd N/A <br />12. Erosion of toe Yes ~ N/A <br />13. water impounded against toe Yes i ' ® N/A <br />14. Existing embankment freeboard (feet) ~I 2~ Feet <br />15. Cracks, bulging, or erosion on ups team Eace 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. Cracking or crushing of pipes <br /> a) Spillway pipes Yes ~ N/A <br /> bl Decant System Yes ® N/A <br />19. Trash racks clear and in place ~ No N/A <br />~.... a • 5 ~<~ <br />c:\data\wpdata\damform.doc <br />9 -z7- °'' <br />