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<br /> <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name : <br />~1osg C ~~ Date : ` <br />~~. <br /> _ <br />Z,o ~y p~ <br />NPDE S ID. No.:C0-0000213 Date Last Inspected : ?s~ (~`r,~,~ p~ <br />' <br />'_• <br />Faci lity Configuration: Total Incised Pond ~ <br />Site Name: Imt~oundment #0014 Location:47N15W SEC 31 <br />Mine Name: New Horizon Mine Location:l mi.NW of Nucla. CO <br /> <br />Mine <br />ID No.: CDMG Permit #0008-81 _ <br />Owners Rep.: R. L. Wade, Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE R ESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., tops oil) ~ No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan <br /> <br />4. <br />Burning (specify extend and location) Yes. <br />Yes No <br />No N/A <br />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 No N/A <br /> b•) At isolated points on embankment slopes: Yes No N/A <br /> c) At natural hillside: Yes No N/A <br /> d) Over widespread areas Yes No N/A <br /> e) From downsteam foundation area Yes No N/A <br /> f) "Boils" beneath strain or ponded water Yes No N/A <br />7. Cracks or scarps on crest <br /> <br />8. <br />Cracks or scraps on slope Yes No N/A <br /> <br />9. <br />Sloughing or bulging on slope Yes No N/A <br /> <br />10. <br />Major erosion problems Yes No N/A <br /> <br />11. <br />Surface movements in valley bottom or on hillside Yes <br />Yes No <br />No N/A <br />N/A <br />12. Erosion of toe <br /> <br />13. <br />Water impounded against toe Yes No N/A <br /> <br />14. <br />Existing embankment freeboard (feet) Yes ~ No N/A <br /> <br />15. <br />Cracks, bulging, or erosion on upsteam face ~ <br />Yes _ <br />® Feet <br />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 ®o N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes No <br /> b) Decant system Yes No <br />19. Trash racks clear and in place Yes No <br /> <br />F:\Eng\DATA\WP\pond-banks\DAMFORM.wpd <br />Q~ <br />