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<br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name : ~a~ ~ ~,~ Date : ~ -ZZ ^ ~ S <br />NPDES ID. No.:CO-0000213 IID~' Date Last Inspected :0~-O ~1-45 <br />Facil ity Configuration:Incised Pond <br />Site Name: Impoundment #012 Location:4 7N16W Sec 36 <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla , CO. <br />Mine ID No.: CDMG Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manacter <br /> CIRCLE OR WRITE IN APPROPRIATE R ESPONSE <br /> <br />1. Foundation Preparation (removal of v <br />e <br />getation, <br />atumpa., tops oil) ~ No N/A <br />2. ~ <br />i <br />/~ <br />Lift thickness (inches) i c /n(~y_ <br /> <br />3. ~ <br />Compaction according to approved plan <br />~ <br />No <br />N/A <br />4. Burning (specify extend and location) Yea No 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 underdrain pipes: Yes ~O N/A <br /> b.) At isolated points on embankment Slopes: Yes ~ N/A <br /> c) At natural hillside: Yes ~ N/A <br /> d) Over widespread areas Yes ~ N/A <br /> e) From downsteam £oundation area Yes (N4 N/A <br /> f) "Boils" beneath stram or ponded water Yes ® N/A <br />7. Cracks or scarps on crest Yea ~ N/A <br />8. Cracks Or Scraps on slope Yes (~I~ 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 Yea L"Na N/A <br />13. Water impounded against toe Yes ~Ny7' N/A <br />14. Existing embankment freeboard (feet) -~I <br />~ Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes N/A <br />16. Visible sumps or sinkholes in sluzry surface Yes ~ N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yes ~ N/A <br /> b) Decant system Yes ~ N/A <br /> C) Diversion Ditches Yes ~ N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yea ~iS~ N/A <br /> b) DCCant System Ye8 ~ N/A <br />19. Trash racks clear and in place V No N/A <br />) S ~r ~1 <br />n° N ~ 0 <br />F:\Eng\DATA\WP\pond-banks\DAMFOFM.wpd <br />~ 2-z _ a-s <br />