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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Michael Altavilla DATE: 09/22/99 <br />NPDES I.D. NO.: N/A <br />FACILITY CONFIGURATION: Incised Pond DATE LAST INSPECTION: 06/30/99 <br />SITE NAME: Truck Wash Settling Pond LOCATION: NW1~ NEB Sec_ 34 T6N RB7W <br />MINE NAME: F n a 77 M;n (c ne a -oal -01 LOCATION: 7.1 m;_. SE of Haden sO <br />MINE I.D. NO.: COMG Permit No. C-BO-005 OWNER'S REP.: Brad Brown, Gen Mgr <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: <br />2. Lift thickness: <br />3. Compaction according to approved plan: <br />4. Burning (specify extent and location): <br />5. Angle of slope: upstream, downstream <br />6. *Seepage (specify location, color, and approximate volume) <br />From underdrain pipes: <br />At isolated points on embankment elopes: <br />At natural hillside: <br />Over widespread areas: <br />From downstream foundation area: <br />"Boils" beneath stream or ponded water: <br />7. Cracks or scarps on crest: <br />8. Cracks or scarps on elope: <br />9. Sloughing or bulging on elope: <br />10. *Major erosion problems: <br />11. Surface movements in valley bottom or on hillside: <br />12. *Eroeion of toe: <br />13. *Water impounded against toe: <br />14. Existing embankment freeboard: See comments <br />15. increase ~ Decrease in water level: <br />16. Cracks, bulging, or erosion on upstream face: <br />17. Visible Bumps or sinkholes in slurry surface: <br />1B. *Clogging <br />Spillway channels and pipes: <br />Decant system: <br />Diversion ditches: <br />19. *Cracking or crushing of pipes <br />Spillway pipes: <br />Decant system: <br />20. Trash racks clear and in place: <br />es No N/A <br />T/A inche <br />s <br /> <br />Yes ~// <br />~~~~ <br />No <br />Yes No <br />Total = ~8 <br />Yea No <br />Yee No <br />Yes No <br />Yee o N/A <br />Yes N/A <br />Yee N/A <br />Yee No <br />Yee No <br />Yes No N <br />Yee ©o N/A <br />Yee No /A <br />Yee No N <br />Yes No <br />e.0 feet <br />3.0 feet <br />Yee ~ N A <br />Yes No N <br />Yes ~ N A <br />Y0s O <br />Yes No <br />Yes <br />Yes No <br />ee 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 described (extent, location, volume, etc.) in the apace <br />on the back of this sheet. <br />