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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name :-1z„ "- ?ka Date: 03M"c?, vC\ <br />NPDES ID. No.:CO-0000213 Date Last Inspected: pZ U $ <br />c, <br />Facility Configuration: Total Incised Pond <br />Site Name: Impoundment #009 Location:47N16W SEC 36 <br />Mine Name: New Horizon Mine Location:l mi.NW of Nucla, CO <br />Mine ID No.: C_DMG 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) No <br />2• Lift thickness (inches) <br />3. Compaction according to approved plan <br />No <br />4. Burning (specify extend and location) <br />Yes <br />No <br />S. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) From underdrain pipes: <br />Yes <br /> b.) At isolated points on embankment slopes: <br />Yes Qa <br /> c) At natural hillside: <br /> <br />d) Over widespread areas Yes CIED <br /> <br />e) From downsteam foundation area Yes (:0) <br /> <br />f) "Boils" beneath straw or ponded water Yes <br /> <br />7. <br />Cracks or scarps on crest Yes No <br />8. Cracks or scraps on slope Yes <br />9. Sloughing or bulging on slope <br /> <br />10. <br />Major erosion problems Yes Q0 <br />11. Surface movements in valley bottom or on hillside Yes ? <br />12. Erosion of toe Yes dEj) <br />13. Water impounded against toe Yes ?o <br />14. Existing embankment freeboard (feet)-54 Yes <br />15. Cracks, bulging, or erosion on upsteam face <br />Ye <br />16. Visible s <br />amps or sinkholes in slurry surface s <br />Yes <br />17. Clogging <br /> a) Spillway channels and pipes <br /> <br />b) Decant system Yes <14 <br /> <br />c) Diversion Ditches Yes <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes <br />Yes <br /> b) Decant system <br />19. Trash racks cleat and in place Yes (Fol <br />No <br /> ?J <br /> P <br /> ??? l5 ?? TF <br /> <br /> <br /> <br />F:\Eng\ DATA\WP\pond-banks\DAMFORM.wpd <br />_C?• <br /> SSIf1AfA1 _r.` " <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 />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 />0 00-1 <br />`^ <br />3 vyl Gr <br />D