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PERIODIC INSPECTION FORM <br />WATER, SIDII~TT, OR SLURRY <br />Inspectors Name : Zots ~~ ~~ Date : b^ I l _ 5g <br />NPDES ID. No.:CO-0000213 005 Date Last Inspected: ¢ -'Z_Qo <br />Facility Configuration:Side Hill Pond <br />Site Name: Impoundment #005 Location:47N16W36AD <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla. CO. <br />Mine ID No.: <br />Owners Rep.: <br /> CIRCLE OR WRITE INAPPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) ~ No N/A <br />2. Lift thiclmess (inches) <br />3. Compaction according to appcwed plan ® No N/A <br />4. Burning (specify extend and location) Yes ~ N/A <br />5. Angle of slope: 3:1 upstream, 3.1 downstream <br />6. Seepage (specify location, color, and approx. volume( <br /> a.) Fran underdrain pipes: Yes ®o N/A <br /> b.) At isolated points on embankment slopes: Yes ®o N/A <br /> c) At natural hillside: Yes ~o N/A <br /> d) Over widespread areas Yes ®o N/A <br /> e) Fran downstream foundation area Yes ® N/A <br /> f) '`Boils" beneath scream or ponded water Yes ~ N/A <br />7. Cracks or scarps on cres[ Yes ~o N/A <br />8. Cracks or scraps on slope Yes ® N/A <br />5. Sloughing or bulging on slope Yes ® N/A <br />10. Major erosion problems Yes ® N/A <br />11. Surface movements in valley bottan or on hillside Yes p~ N/A <br />12. Erosion of tce Yes ® N/A <br />13. Water impounded against toe Yes 1 ~ N/A <br />14. 6ci sting embarJmient freeboard (feet) 1/ L Feet <br />15. Cracks, bulging, or erosion on upstream face Yes ® N/A <br />16. Visible songs or sinkholes in slurry surface Yes ® N/A <br />17. Clogging <br /> <br />a) Spillway channels and pipes <br />Yes ~T <br />Ti0 <br />N/A <br /> b) Decant system Yes ® N/A <br /> c) Diversion Ditches Yes ~ N/A <br />19. Cracking or crushing of pipes <br /> a) Spillway pipes Yes N/A <br /> b) Decant system Yes N/A <br />19. Trash racks clear and in place ® No N/A <br />~on~ ~5 a,~'~ .-• ~ a1sv~.e~~ <br />