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41 <br /> <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name 1 ,, ? G"Y-O- <br />NPDES ID. No.:CO-0000213 <br />Date : Oct O 8 <br />Date Last Inspected: Id Svhe c* <br />Faci.li.ty Configuration: Total Incised Pond <br />Site Name: Impoundment #008 Location:46N15W SEC 6 <br />Mine Name: New Horizon Mine Location:l mi.NW of Nucla. CO <br />Mine ID No.: CDMG Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manaqer <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) Ye No N/A <br />2 <br /> Lift thickness (inches) <br />3. Compaction according to approved plan Ye No N/A <br />4. Burning (specify extend and location) Yes 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 N/A <br /> d) Over widespread areas Yes ® N/A <br /> e) From downsteam foundation area Yes ® N/A <br /> f) "Boils" beneath stram or ponded water Yes @ N/A <br />7. Cracks or scarps on crest Yes ® N/A <br />8. Cracks or scraps on slope Yes @ N/A <br />9. Sloughing or bulging on slope Yes N/A <br />10. Major erosion problems Yes N/A <br />il. Surface movements in valley bottom or on hillside Yes N/A <br />12. Erosion of toe Yes N/A <br />13. Water impounded against toe Yes N/A <br />14. Existing embankment freeboard (feet)?(? $$ <br />4• - SAS) " ' <br /> <br />is. _ <br />Cracks, bulging, or erosion on upsteam face 7• <br />Yes 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 N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes N/A <br /> b) Decant system Yes N/A <br />19. Trash racks clear and in place Ye No N/A <br />No a.s C)wr, -e %--Q'- <br />F:\Eng\DATA\WP\pond-banks\DAMFORM.wpd <br />OO REG/S, <br />IIJ <br />o?,y? Gam' ?o <br />v'O <br />'ac 5 <br />• V