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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br /> <br />INSPECTOR'S NAME: Ron Gehrke DATE: OS/01/91 <br />NPDES I.D. NO.: - <br />FACILITY CONFIGU : Incised Pond DATE LAST INSPECTION: 05/07/91 <br />SITE NAME: Wad a Im oundment #002 LOCATION: NW'/. NE'/. Sec. 34 T6N R87'W <br />MINE NAME: eneca ine ea o y oa o LOCATION: mi. o ay en, <br />MINE I.D. N ,: ermi - - OWNER'S R .: Scott Williams. Suot <br /> Circle or write in appropriate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoil): _ Yes No <br />2. Lift thickness: in. /A <br />3. Compaction according to approved plan: Yes No N/ <br />4. Burning (specify extent and location): Ives, No <br />5. Angle of slope: upstream, downstream Total = - N/A <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes: Yes No CN/q~ <br /> At isolated points on em an ment s open: Yes N <br /> At natural hillside: Yes N/A <br /> Over widespread areas: Yes Ne <br /> From downstream foundation area: Yes No N <br /> "boils" beneath stream or ponded wa er: Yes ~ N/A <br />7. Cracks or scarps on crest: Yes No /A <br />8. Cracks or scarps on slope: Yes No N A <br />9. Sloughing or bulging on slope: Yes No /A <br />10. *Major erosion problems: Yes No N/A <br />11. Surface movements in valley bottom or on hillside: Yes ldn N/A <br />12. *Erosion of toe: Yes No N/,4 <br />13. *Water impounded against toe: Yes No N A <br />14. Existing embankment freeboard: N/A fee t <br />15. Increase X Decrease in water level: 2.5 fee t <br />16. Cracks, bulging, or erosion on upstream face: Yes No N/A <br />17. Visible sumps or sinkholes in slurry surface: Yes No N/A <br />18. *Clogging <br /> Spillway channels and pipes: Yes No N/A <br /> Decant system: Yes No ~A~ <br /> Diversion ditches: Yes No N/A <br />19. *Cracking or crushing of pipes <br /> Spillway pipes: Yes No N A <br /> Decant system: Yes No t~A <br />20. Trash racks clear and in place: Yes No /A <br />*Major adverse changes in these items could cause instability and should be reported to <br />the Engineering Manager and Mine Superintendent for further evaluation. Adverse condi- <br />tions noted in these items should normally be described (extent, location, volume, etc.) <br />in the space on the back of this sheet. <br />