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PERIODIC INSPECTION FORM <br />HATER, SIDII~PT, OR SLURRY <br />Inspectors Name : ~o R Date : ~ „ ~, ,. Q ( , <br />NPDES ID. No.: CO-0000213 003 Date Last Inspected: ~. Z,t, q ~ <br />Facility Configuration:Side Hill Pond <br />Site Name: ~oundment #003 Location: 47N16W36BC <br />Mine Name: New Horizon Mine Location: 2 mi.NW of Nuc la, CO. <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owners Rep.: R. L. Wade. Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (remov-al of vegetation, sturtq~s., topsoil) Ye No N/A <br />2. Lift thickness (inches) <br />3. Conq~action according to approved plan es No N/A <br />4. Burning (specify extend and location) Yes 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.) From underdrain pipes: Yes No Q~ <br /> b.) At isolated points on embankment slopes: Yes ~ N/A <br /> c) At natural hillside: Yes Q N/A <br /> d) Over widespread areas Yes @ N/A <br /> e) From downstream foundation area Yes No N/A <br /> f) "Boils" beneath scream or ponded water Yes o N/A <br />7. Cracks or scarps on crest Yes ® N/A <br />8. Cracks or scraps on slope Yes ~ 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 tce Yes ~ N/A <br />13. Water ir~ounded against tce Yes ~ ~ N/A <br />14. Existing embankment freeboard (feet) ~ Feet <br />15. Cracks, bulging, or erosion on upstream face Yes ~ N/A <br />16. Visible sunq~s or sinkholes in slurry surface Yes ~. N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yes No <br /> b) Decant system Yes No I~. <br /> c) Diversion Ditches Yes No ~. <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes No [ */ <br /> b) Decant system Yes No <br />19. Trash racks clear and in place Yes No ~~ <br /> <br />~ NJI <br />o?F~E R S `STS` <br />~ r v ~~ G~ '`per <br />:~ <br />~~ b <br />~9~~SSrorva~E`'G~~ <br />~, ~9c <br />