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<br /> <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name :SS.bk? Date: <br />NPDES ID. No.:-0-0000213 Date Last Inspected: <br />U Z.. oec., og <br />Facility Configuration: Total Incised Pond <br />Site Name: Impoundment #0014 Location:47N15W SEC 31 <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 Mana er <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., <br />2. Lift thickness topsoils No N/A <br />(inches) <br />3. Compaction according to approved plan <br />4. Burning (specify extend and location) No <br />5. Angle of slope: 3:1 upstream, 3.1 downstream s <br />Yes i? <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) From underdrain pipes: <br /> b•) At isolated points on embankment slopes: Yes ?N <br /> c) At natural hillside: Yes ? <br /> d) Over widespread areas Yes (L19 <br /> e) From downsteam foundation area Yes <br /> f) "Boils" beneath stram or Ponded water Yes <br />7. Cracks or scarps on crest Yes <br />8. Cracks or scraps on slope Yes No <br />9. Sloughing or bulging on slope Yes ? <br /> <br />10. <br />Major erosion.problems <br />Yes x <br />11. Surface movements in valley bottom or on hillside Yes <br />12. Erosion of toe Yes <br />13. Water impounded against toe Yes <br />14. Existing embankment freeboard (feet) $`7 <br />4 5- 5733t r Yes rpm <br />15. ) <br />_ <br />Cracks, bulging, or erosion on upsteam face <br />16. Visible sumps or sinkholes in slurry surface Yes <br />17. Clogging Yes <br /> a) Spillway channels and pipes <br /> b) Decant system Yes No <br /> C) Diversion Ditches Yes No <br />18. Cracking or crushing of pipes Yes No <br /> a) Spillway pipes <br /> b) Decant system Yes No <br />19. Trash racks clear and in place Yes No <br />7;?) %5?1nG <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 /> <br />A <br />< <br />'?7 <br />03