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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: NPDES ID. NO.:CO-0000213 <br />Date: pZ :?v,?,a p?k <br />Date Last Inspected: 03 ?`'?cY c?,, o <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) Ye No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan Ye No <br />4. Burning (specify extend and location) Yes <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 QD <br /> b.) At isolated points on embankment slopes: Yes <br /> c) At natural hillside: Yes <br /> d) Over widespread areas Yes (P. <br /> e) From downsteam foundation area Yes <br /> f) "Boils" beneath stram or ponded water Yes <br />7. Cracks or scarps on crest Yes (ED <br />8. Cracks or scraps on slope Yes o <br /> <br />9. <br />Sloughing or bulging on slope <br />Yes f <br />(ID <br />10. Major erosion problems Yes <br />11. Surface movements in valley bottom or on hillside Yes D <br />12. Erosion of toe Yes ID <br />13. Water impounded against toe Yes V <br />14. Existing embankment freeboard (feet) "7• I <br />15. Cracks, bulging, or erosion on upsteam face Yes <br />16. visible sumps or sinkholes in slurry surface Yes N® <br />17. Clogging <br /> a) Spillway channels and pipes Yes <br /> b) Decant system Yes <br /> c) Diversion Ditches Yes <0 <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes <br /> b) Decant system Yes <br />19. Trash racks clear and in place Ye No <br />IS. r o-? ??Sc.c p REG? <br />an <br />?P?E1?l1S' s?`c9 <br />O Z A I-A. •--e. d <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 />F:\Eng\DATA\WP\pond-banks\DAMFORM.