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PERIODIC INSPECTION FORM RECEI\/ED <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Michael Altavi77a DATE: 09/2597 ~CI ~ O ~~~~ <br />NPDES I.D. NO.: CO-0000221 O.P. 003 <br />FACILITY CONFIGURATION: Diked Pond DATE LAST INSPECTI~IYISirebd,~$OrdAa~o ~~ i <br />SITE NAME: Northwest Imnoendment k00a '~'°C~%IOOy <br />LOCATION: SEk sW'.~ Sec. 27. T6N R87W " <br />MINE NAME: sen a II M'n (seneca coal cod LOCATION: 7.t mi_ sE of Hayd ~n ,_s0 _ <br />MINE I.D. NO.: -MT.Rn pe m+ No. --80-OOS OWNER'S REP.: Brad Brown. Gen Mar <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: _ ~ No N/A <br />2. Lift thickness: 1Z in. N/A <br />3. Compaction according to approved plan: ® No N/A <br />4. Burning (specify extent and location): Yee No <br />5. Angle of elope: 2:1 upstream, 3cl downstream Total = Scl N/A <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes: Yee No /A <br /> At isolated points on embankment elopes: Yee <br /> At natural hillside: Yea N/A <br /> Over widespread areas: Yes ~ N/A <br /> From downstream foundation area: Yes ® N/A <br /> "Boils" beneath stream or ponded water: Yee ® N/A <br />7. Cracks or ecarpe on treat: Yee N/A <br />8. Cracks or ecarpe on elope: Yes ~ N/A <br />9. Sloughing or bulging on elope: Yee ~ N/A <br />10. *Major erosion problems: Yea ®° N/A <br />11. Surface movements in valley bottom or on hillside: Yes o N/A <br />12. *Eroeion of toe: Yee No N/A <br />13. *Water impounded against toe: Yes ~ N/A <br />14. Existing embankment freeboard: see comments 4.9 feet <br />15. Increase Decrease in water level: No change feet <br />16. Cracks, bulging, or erosion on upstream face: Yee ~ N/A <br />17. Visible sumps or sinkholes in slurry surface: Yes No <br />18. *Clogging <br /> Spillway channels and pipes: Yes ©o N/A <br /> Decant system: Yee No <br /> Diversion ditches: Yea ~ N/A <br />19. *Cracking or crushing of pipes <br /> Spillway pipes: Yee ~ N A <br /> Decant system: Yee No <br />20. Trash racks clear and in place: es No N/A <br />*Major adverse changes in these items could cause instability and should be reported to the <br />Engineering Manager and Mine Superintendent for further evaluation. Adverse conditions noted <br />in these items should normally be deecribed (extent, location, volume, etc.) in the space on <br />the back of this sheet. <br />