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PERIODIC INSPECTION FORM <br />HATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: /«~ C ^--~•f <br />NPDES ID. No.: CO-0000213 004 <br />Facility Configuration: Sidehill Pand <br />Site Name: Impoundment # B84 <br />Mine Name: New Horizon Mine Western Fuels-Co <br />Mine ID No.:CMLRD Permit #0080-81 <br />Owners Rep.: R, L. Wade, Mine Manager <br />I. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />8. <br />9. <br />10. <br />11. <br />12. <br />13. <br />14. <br />15. <br />16. <br />17. <br />10. <br />Date• 5~6~ gy <br />Date•Last Inspected: r 5-9y <br />Location: 47NISW3IBC <br />Location:2 mi. NW of Nucla, Cm. <br />CIRCLE OR NRITE IN APPROPRIATE RESPONSE <br />Foundation Preparation (removal of vegetation, stumps, topsoil) <br />Lift thickness (inches): /2 ..,gybes <br />Compaction according to approved plan: <br />Burning (specify extent and location): <br />Angle of slope: 3:1 upstream, 3:1 downstream, <br />Seepage (specify location, color, and approx. volume) <br />From underdrain pipes: <br />At isolated points on embankment slopes: <br />At natural hillside: <br />Over widespread areas: <br />From downstream foundation area: <br />'Boils" beneath stream or ponded water: <br />Cracks or scarps on crest: <br />Cracks or scarps on slope: <br />Sloughing or bulging on slope: <br />+Major erosion problems: <br />Surface movements in valley bottom or on hillside: <br />+Erosion of tae: <br />+Water impounded against toe: <br />Existing embankment freeboard Ifeet): <br />increase or decrease in water level (feet): <br />Cracks, bulging, or erasion on upstream face: <br />Visible sumps or sinkholes in slurry surface: <br />+Clagging <br />Spillway channels and pipes: <br />Decant systee: <br />Diversion ditches: <br />19. +Cracking or crushing of pipes <br />Spillway pipes:_ <br />-ecant systems _ <br />20. Trash racks clear and <br />in place: <br />+Major adverse changes to these items could cause <br />to the Chief Engineer and Mine Manager for furth <br />noted in these items should normally 6e desc <br />on page two of this inspection form. Q'~ <br />~i`o5'~~ / 5 <br />® No N/A <br />Yes No N/A <br /> No N/A <br />Yes ~ N/A <br />Tota l 6e1 <br />Yes No <br />Yes ® N/A <br />Yes ® N/A <br />Yes ® N/A <br />Yes ®o N/A <br />Yes ~ N/A <br />Yes ® N/A <br />Yes ~ N/A <br />Yes ~ N/A <br />Yes (~q N/A <br />Yes N/A <br />Yes C~ N/A <br />Yes Nn N/A <br />//.5 Feet <br />O Feet <br />Yes N N/A <br />Yes N N/A <br />Yes (N N/A <br />Yes ~lNo N/A <br />Yes No /A <br />Yes No N/A <br />Yes N/A <br />es No N/A <br />instability and should be reported <br />:on. Adverse conditions <br />b?~~~, location, volume, etc.) <br />5- g-9`~ <br />