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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impo~lundments <br />INSPECTOR'S NAME: Dennis Jones DATE: 3-ao_o6 <br />NPDES I.D. NO.: CO-0000221 D.P. 003 <br />FACILITY CONFIGURATION: Diked Pond <br />SITE NAME: Northwest Impoundment #003 <br />MINE NAME: Seneca ZI Mine (Seneca Coal Co) <br />MINE I.D. NO.: CMLRD Permit No. C-80-005 <br />DATE LAST INSPECTION: I1'Z3 _ oS <br />LOCATION: SE'/, SW'/.. Sec. 27. T6N. R87W <br />LOCATION: 7.1 mi. SE of Havden. CO <br />OWNER'S REP.: Greaa Kitchen, Gen Mar <br />Circle or write in appropriate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: Yes <br />2. Lift thickness: 12 in. <br />3. Compaction according to approved plan: Yes <br />4. Burning (specify extent and location): No <br />5. Angle of slope: 2:1 upstream, 3:1 downstream Total = 5:1 <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes: N A <br /> At isolated points on embankment slopes: Yes o N/A <br /> At natural hillside: Yes o N/A <br /> Over widespread areas: Yes o N/A <br /> From downstream foundation area: Yes No N/A <br /> "Boils" beneath stream or ponded water: Yes No N/A <br />7, Cracks or scarps on crest: Yes No N/A <br />8. Cracks or scarps on slope: Yes No N/A <br />9. Sloughing or bulging on slope: Yes No N/A <br />10. *Maj or erosion problems: Yes No N/A <br />11. Surface movements in valley bottom or on hillside: Yes No N/A <br />12. *Erosion of toe: Yes No N/A <br />13. *Water impounded against toe: Yes N/A <br />14. Existing embankment freeboard: (normal = 4.9') ~ feet <br />15. Increase Decrease in water level: loo ~~.d feet <br />16. Cracks, bulging, or erosion on upstream face: Yes No N/A <br />17. Visible sumps or sinkholes in slurry surface: N~_A_ <br />18. *Clogging <br /> Spillway channels and pipes: Yes ~ N/A <br /> Decant system: <br /> Diversion ditches: Yes ~ N/A <br />19. *Cracking or crushing of pipes <br /> Spillway pipes: Yes No N/A <br /> Decant system: L <br />20. Trash racks clear and in place; Yes 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 in <br />these items should normally be described (extent, location, volume, etc.) in the space on the <br />back of this sheet. <br />