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I~ <br />.- r <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />}~t.c~ <br />Inspectors Name:~~.~~ C„x„14„ <br />NPDES ID. No.:CO-0000213 <br />Facility Configuration: Total Inc <br />Site Name: Impoundment #0014 <br />Mine Name: New Horizon Mine <br />Mine ID No.: CDMG Permit #0008-81 <br />Date: 63- 1Z-C"l <br />Date Last Inspected: 1 L - Q (,. ~ C! ~ <br />ised Pond - <br />Location:47N16W SEC 31 <br />Location:l mi.NW of Nucla, CO. <br />Owners Rep.: R. L. Wade, Mine Manager <br /> CIRCLE OR WRZTE IN APPROPRIATE RESP ONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) Yes No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan Yes 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.) From underdrain pipes: Yes ®° N/A <br /> b.) At isolated points on embankment slopes: Yes (N~i N/A <br /> c) At natural hillside: Yes ~ N/A <br /> d) Over widespread areas Yes N N/A <br /> e) From downsteam foundation area Yes ')3 N/A <br /> f) "Boils" beneath strain or ponded water Yes ~ N/A <br />7.~ Cracks or scarps oa treat Yes ~ N/A <br />8. Cracks or scraps on elope Yes ~ <br />J N/A <br />9. Sloughing or bulging on slope Yes NCJ N/A <br />10. Major erosion problems Yea ~ N/A <br />11. Surface movements in Valley bottom or On hillside Yes ([~ N/A <br />12. Erosion of toe Yes ~ N/A <br />13. Water impounded against toe Yes ~ <br /><"Y N/A <br />14. Existing embankment freeboard (feet} ~ / Feet <br />15. Cracks, bulging, or erosion on upateam face Yes ® N/A <br />16. Visible sumps or sinkholes in slurry surface Yes ~ N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yea No <br /> b) Decant system Yes No N~ <br /> c) Diversion Ditches Yes No N~ <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes No Nr/T)4 <br /> b) Decant system Yes No <br />19. Trash racks clear and in place Yes No N <br />)-S ~l )Yy <br />F:\Eng\DATA\WP\pond-banks\DAMFORM.wpd <br /> <br />