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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Dennis Jones <br />NPDES I.D. NO. N A <br />FACILITY CONF7:GURATION: Incised Pond <br />SITE NAME: Truck Wash Supply Pond <br />MINE NAME: Seneca Mine II (Seneca Coal Co) <br />MINE I.D. NO. CDMG Permit No. C-80-005 <br />1 <br />2 <br />3 <br />4 <br />5 <br />6 <br />7. <br />8. <br />9. <br />10 <br />11 <br />12 <br />13 <br />14 <br />15 <br />16 <br />17 <br />18 <br />19 <br />20 <br />21 <br />Foundation preparation <br />Lift thickness: <br />Compaction according to <br />Burning (specify extent <br />Angle of slope: 2:1 <br />DATE: ~~- IS' -U~ <br />DATE LAST INSPECTION: `-~-~~ <br />LOCATION: NW1/ NE1/ Sec 34 T6N, R87W <br />LOCATION: 7 1 mi SE of Hayden, CO <br />OWNER'S REP.: Grec(a Kitchen Gen Mar <br />Circle or write in apAropriate response <br />(removal of vegetation, stumps, topsoil: Yes <br />12 inches <br />Yes <br />approved plan: <br />No <br />and location): <br />2:1 downstream Total = 4:1 <br />_ upstream, <br />for and approximate volume) <br />*Seepage (specify location, co <br />From underdrain pipes: <br />t isolated points on embankment <br />slopes: Yes <br />Yes No <br />No <br />A. <br />At natural hillside: Yes No <br />Over widespread areas: Yes No <br />From downstream foundation area: yes No <br />'Boils" beneath stream or ponded water: yes No <br />Cracks or scarps on crest: Yes No <br />Cracks or scarps on slope: Yes No <br />Sloughing or bulging on slope: yes No <br />*Major erosion problems: <br />hillside: Yes No <br />Surfaces movements in valley bottom or on yes No <br />*Erosio~~ of toe: Y <br />e <br />s No <br />*Water :impounded against toe: ' . <br />~ <br />- <br />-~ <br />a•I feet <br />Existing embankment freeboard: ( ) <br />normal - 2 7 <br />~ feet <br />Increase Decrease in water ~o-Q <br />level: i~t.o G - <br />Yes <br />Cracks, bulging, or erosion on upstrea m face: ~ <br /> <br />Visible sumps or sinkholes in slurry surface: - <br />*Clogging Yes <br />Spillway channels and pipes: <br />Decant system: Yes loo <br />Diversion ditches: <br />*Cracking or crushing of pipes Yes No <br />Spillway pipes: ~A <br />Decant system: N~ <br />Trash racks clear and in place: <br />~~ W~a'~~' <br />~ 1 ~ <br />ccd CK~ve~'~ Owl ~ O6 ~ <br />°' ~• <br />c <br />Discharge rate (gpm) a <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />*Major adverse changes in these items could cause instability and should be reported to the <br />Engineering shougld normally bepdescribed t(extentrtlocationuavolume A etc S)e i ondhe spaceoondthe <br />these items <br />back of thi;~ sheet. <br />