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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name:?? .. Date: crz.Dsr e"R <br />NPDES ID. No.:CO-0000213 Date Last Inspected: Qo <br />Facility 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 Manager <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation preparation (removal of vegetation, stumps., topsoil) Cs No N/A <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 />is <br />16 <br />17 <br />is. <br />19. <br /> <br />Lift thickness (inches) <br />Compaction according to approved plan No <br />Burning (specify extend and location) Yes <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />Seepage (specify location, color, and approx. volume) <br />a.) From underdrain pipes: Yes <br />b.) At isolated points on embankment slopes: Yes <br />c) At natural hillside: Yes (95) <br />d) Over widespread areas Yes <br />e) From downsteam foundation area Yes <br />f) "Boils" beneath strain or ponded water Yes <br />Cracks or scarps on crest Yes <br />Cracks or scraps on slope Yes <br />Sloughing or bulging on slope Yes <br />Major erosion problems Yes <br />Surface movements in valley bottom or on hillside Yes Q <br />Erosion of toe Yes <br />Water impounded against toe Yes <br />Existing embankment freeboard (feet) %58.; 5(„ Bh L ?- <br />1 <br />Cracks, bulging, or erosion on upsteam face + <br />Yes <br />visible sumps or sinkholes in slurry surface Yes <br />Clogging <br />a) Spillway channels and pipes Yes <br />b) Decant system Yes <br />c) Diversion Ditches Yes <br />Cracking or crushing of pipes <br />a) Spillway pipes Yes 1 <br /> <br />b) Decant system <br />Yes 3 <br />Trash racks clear and in place <br />r0'3, '4`1? <br />F:\Eng\DATA\Wp\pond-banks\DAMFORM.wpd <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 />Feet <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 />