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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: 1~s5 G.~~oko Date: 9-~'Z-cp <br />NPDES ID. No.:CO-0000213 005 Date Last Inspected :(-Z.1-oo <br />Faci lity Configuration:Side Hill Po nd <br />Site Name: Impoundment #005 Location:97N16W36AD <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucl a. CO. <br /> <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manag er <br /> CIRCLE OR WRITE IN APP ROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation , stumps., topsoil) ~ 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.l From underdcain pipes: Yes ® N/A <br /> b.l At isolated points on embankment slopes: Yes ~ N/A <br /> c) At natural hillside: Yes ~1rn N/A <br /> d) Over widespread areas Yes ~, N/A <br /> e) From downsteam foundation area Yes ®, N/A <br /> f) "Boils" beneath scram or ponded eater Yes ~ N/A <br />7. Cracks O[ sCdlpS on C[e5t Yes ® N/A <br />8. rracks or scraps on slope Yes ®, 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 toe Yes ~ N/A <br />13. Water impounded against toe Yes <br />/ ® N/A <br /> l <br />14. Existing embankment freeboard (feet) 'I t Feec <br />15. Cracks, bulging, or erosion on ups team 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 /> 61 Decant system Yes ~ N/A <br /> c) Diversion Di tche5 Yes ® N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes ®i N/A <br /> b) Decant system Yes ~ N/A <br />19. Trash racks clear and in o N/A <br />c: \data\wpda[a\damform.doc <br />~-z7, v <br />