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PERIODIC INSPECTION FORM <br />V~,TER, SIDIl~TP, OR SLURRY <br />Inspectors Name : 'R _ L _ ub~ Date : -~ _ -Z(- Q Z <br />NPDES ID. No.:CY~-0000213 004 Date Last Inspected : (_~-Z_q~-~ <br />Facility Configuration:Side Hill Pond <br />Site Name: Itt~loundment #004 Location:4 7N16W36CB <br />Mine Name: New Horizon Mine Location:2 [rd .NW of Nucl a CO. <br /> <br />Mine ID No.: QKLRD Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil)~e No N/A <br />2. Lift thickness (inches) /'Z /N~ <br />3. Cortpaction according to approved 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 ~ N/A <br /> b.) At isolated points on embankment slopes: Yes ® N/A <br /> c) At natural hillside: Yes ®o N/A <br /> d) Over widespread areas Yes ® 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 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 rtrrvements in valley bottom or on hillside Yes ~ N/A <br />12. Erosion of tce Yes ®, N/A <br />13. Water impounded against tce Yes ® N/A <br />19. Existing embankment freeboard (feet) ~ __ Feet <br />15. Cracks, bulging, or erosion on upstream 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 Yes ~ N/A <br /> b) Decant system Yes ® N/A <br /> c) Diversion Ditches Yes ® N/A <br />18. 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 ~ <br />~::~- No N/A <br />Qd~~ i5 ~~~ <br />3- a~- 91 <br />