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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Names ~"~ G°"'~~ <br />NPDE5 ID. Nm.: CD-0000213 003 <br />Facility Configuration: 5idehill Pond <br />Site Name: Impoundment t BB3 <br />Mine Name: New Horizon Mine Western Fuels-Co <br />Mine ID No.:CMLRD Per nit i000B-BS <br />Owners Rep.: R. L. Node. Mine Manamer <br />Date: 5~~ ~9Y <br />Date Last Inspected: i-5-a <br />Location: 47N15N31CH <br />Location:2 mi. NN of Nucla, Co. <br />CIRCLE OR NRITE IN APPROPRIATE RE6PON6E <br />1. foundation Preparation (removal of vegetation, stumps, tmpsail) es Ho N/R <br />2. Lift thickness (inches): Yes No <br />3. Cmmpaction according to approved plan: ® No N/A <br />4. Burning (specify extent and location): Yes 407 N/A <br />5, Angle of slope: 3:1 upstream, 3:1 downstream, Total = 6:1 <br />b. Seepage (specify location, color, and approx. volume) <br /> From underdrain pipes: Yes No~ <br /> At isolated points an embankment slopes: Yes ~ N/A <br /> At natural hillsides Yes H/A <br />~ <br /> Over widespread areas: Yes p~ <br />p <br />N/A <br /> From downstream foundation area: Yes N/A <br />~- ~ <br /> °Boils° beneath stream or ponded water: Yes ~ N/A <br />7. Cracks or scarps on crest: Yes o N/R <br />B. Cracks or Scarps on slope: Yes o N/A <br />9. Slmughing or bulging on slope: Yes o N/A <br />10. +Majar erosion problems: Yes o ~ N/A <br />11. Surface movements in valley bottom or on hillside: Yes N~o] N/A <br />12. +Erosion of toe: Yes (N~ N/A <br />13. +Water impounded against tae: Yes o N/R <br />14. Existing embankment freeboard (feet): 2 Feet <br />15. increase or ~ decrease in water level tfeet): / Feet <br />16. Cracks, bulging, or erosion on upstre _ <br />am face: Yes N/A <br />17. Visible sumps or sinkholes in slurry surface: Yes N!R <br />I8. +Clogging <br /> <br />Spillway channels and pipes: <br />Yes -~ <br />No N/ <br /> Decant system( Yes No N/A_. <br /> Diversion ditches: Yes No N/A <br />l9, +Cracking or crushing of pipes <br /> Spillway pipes: Yes No N/A~ <br /> Decant system: Yes No , <br />' <br />20. Trash racks clear and in place: Yes Nm N/A <br />+Majar adverse changes to these items could cause instability and should be reported <br />to the Chief Engineer and Mine Manager for fur valuation. Adverse conditions <br />noted in these items should normally be RE®}S tent, location, volume, etc.) <br />on page two of this inspection form. PP •GWIS, :Fq_ <br />7J n <br />l a/' 5-9-9 <br />