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,~. <br /> <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Tfame : Igo ~ G~.bks,~ Date : ~ 3 I~ a r~ <br />NPDES ID. No.:CO-0000213 Date Last Inspected: ~'~p~/O-j <br />Facility Cor.~figuration:Incised Pond <br />Site Name: Impoundment #012 Location:47N16W Sec 36 <br />Mine Name: IVew Horizon Mine Location: 2.mi.NW of Nucla. CO. <br />Owners Rep.: R. L. Wade, Mine Manager <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) ® No N/A <br />Mine ID No.: CDMG Permit #0008-81 <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 />Lift thickness (inches) <br />Compaction according to approved plan <br />Burning (specify extend and location) <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />Seepage (specify location, color, and approx. volume) <br />a.) From underdrain pipes: <br />b.) At isolated points on embankment slopes: <br />c) At natural hillside: <br />d) Over widespread areas <br />e) From downsteam foundation area <br />f) "Boils" beneath stram or ponded water <br />Cracks or scarps on crest <br />Cracks or scraps on slope <br />Sloughing ~~r bulging on slope <br />Major erosion problems <br />Surface movements in valley bottom or on hillside <br />Erosion of toe <br />Water impounded against toe <br />Existing embankment freeboard (feet) <br />Cracks, bulging, or erosion on upsteam face <br />Visible sumps or sinkholes in slurry surface <br />Clogging <br />a) Spillway channels and pipes <br />b) Decant system <br />c) Diversion Ditches <br />Cracking o:r crushing of pipes <br />a) Spillway pipes <br />b) Decant system <br />Trash racks clear and in place <br />F:\Eng\DATA\WP\pond-banks\DAMFORM.wpd <br />`' :~ ~ <br />v: ~~~. <br />,~ ^•~;' ~ / <br />Yes ~ N/A <br />Yes <br />Yes ~, <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes (~/ <br />Yes <br />~ I <br />Yes <br />Yes Nq <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 />Feet <br />N/A <br />N/A <br />Yes @ N/A <br />Yes No N/A <br />Yes No N/A <br />Yes ~3y N/A <br />Yes ~ N/A <br />es No N/A <br />tin ~CC~/n <br />~~~ % Q <br />-Q~. (V , <br />(~` ~ • .~ <br />~~~KMIA1-~ <br />~3 ~a~~ o~ <br />