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PERIODIC INSPECTION FORM <br />SPater, Sediment, or Slurry Imyoundmente <br />INSPECTOR'S NAME: ~ekv.e5 ~ OheS DATE: ~(-ZS-C7~ <br />NPDES I.D. NO.; CO-0000221 D.P. 003 <br />FACILITY CONFIGURATION: Diked Pond DATE LAST INSPECTION: ~'~ S ~ ~ <br />SITE NAME: Northwest Impoundment #003 LOCATION: SEy SW'/. Sec. 27, T6N, R87W <br />MINE NAME: Seneca II Mine (Seneca Coal Co) LOCATION: 7.1 mi. SE of Hayden, CO <br />MINE I.D. NO.: CMLRD Permit No. C-80-005 OWNER'S REP.: Greoa Kitchen, Gen Mar <br />Circle or write in auyroyriate reeoonee <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: Yes No N/A <br />2. Lift thickness: 12 in. N/A <br />3. Compaction according to approved plan: Yes No N/A <br />4. Burning (specify extent and location): Yes No N/A <br />5. Angle of slope: 2:1 upstream, 3:1 downstream Total = 5:1 N/A <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes: Yes No NL <br /> At isolated points on embankment slopes: Yes No N/A <br /> At natural hillside: Yes No N/A <br /> Over widespread areas: Yes No 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. *Major 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 No N/A <br />14. Existing embankment freeboard: (normal = 4.9') y.~ feet <br />15. Increase Decrease in water level: L.o e.~ev~a P feet <br />16. Cracks, bulging, or erosion on upstream face: Yes ® N/A <br />17. Visible sumps or sinkholes in slurry surface: Yes No NL <br />18. *Clogging <br /> Spillway channels and pipes: Yes ~ N/A <br /> Decant system: Yes No NL <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 <br />20. Trash racks clear and in place: ~e~s` 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 />