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PERIODIC INSPECTION FORM <br />Yrter, Sediment, or Slurry I~poundieents <br />INSPECTOR'S NAME: <br />:'1N.P.D.E.S. I.D. NO.: CO-0000221 D. P. 002 <br />~ILITY CONFI6lR ATION: Incised Pond <br />E NAME: Wad a Im oundment #002 <br />NE NAME: Seneca Mine Peabo~d Coa~Com an <br />MINE I.D. NO.: CMLRB Permit No. C-005 ~6 <br />DATE: <br />DATE LAST INSPECTION: <br />LOCATION: NW;NE:, Sec., ~Fs7W <br />LOCATION: mi. o ay en, <br />OWNER'S REP.: on u ion, up . <br />Circle or write in appropriate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoil?) N/A <br />2. Lift thickness (inches) N/A <br />3. Compaction according to app roved plan N/A <br />4. Burning (specify extent and location) N/A <br />5. Angle of slope ~dagwac~ N/A <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes N/A <br /> At isolated points on embankment s opes N/A <br /> At natural hillside N/A <br /> Over widespread areas A <br /> From downstream founds ion area A <br /> 'Boils° beneath stream or ponde water N/A <br />7. Cracks or scarps on crest N/ A <br />~~9. Cracks or scarps on slope N/ A <br />• Sloughing or bulging on slope N/ A <br />10. *Ma~or erosion problems <br />11. Surface movements in valley bottom or on hillside <br />12. *Erosion of toe N/ A <br />13. *Water impounded against toe N/ A <br />14. Existing embankment freeboard (feet) N/ A <br />15. Increase Decrease in water level (feet) <br />16. Cracks, bulging, or erosion on upstream face N/ A <br />17. Visible sumps or sinkholes in slurry surface N /A <br />1B. *Clogging <br /> Spillway channels and pipes <br /> Decant system <br /> Diversion dit es <br />Yes No <br />ike-~-ile- <br />Yes No <br />Yes No <br />Y ee-.:r <br />Y e5~:;.. <br />-_-feeit- <br />feet <br />Yes No <br />Yes No <br />19. *Cracking or Crushing of pipes <br />Spillway pipes Yes No <br />Decant system ~~-+:e-- <br />20. Trash racks clear and in place N/A -i'e~s--No- <br />=~or adverse changes in these Items could cause instability and should be reported to <br />t~~e Engineering Manager and Mine Superintendent for further evaluation... Adverse condi- <br />tions noted in these items should normally be described (extent, location, volume, etc.) <br />1n the space on the back of this sheet. <br />7-11-3 <br />