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r• <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name : ?.s5 ?b Date: <br />NPDES ID. No.:CO-0000213 Date Last Inspected: o3?rn?aQc?c?°? <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 Manaqer <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) Yes No N/A <br />2. 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 underdr ' <br /> ain pipes: Yes <br /> b.) At isolated points on embankment slopes: Yes ?r , <br /> c) At natural hillside: <br />Yes <br /> d) Over widespread areas Yes No <br /> e) From downsteam foundation area <br />f <br />" Yes No <br /> <br /> <br />7 ) <br />Boils" beneath stram or ponded water <br />Yes <br />No <br />. Cracks or scarps on crest <br />Yes <br />8. <br /> <br />9 Cracks or scraps on slope <br />Yes <br />. Sloughing or bulging on slope <br /> <br />10. <br />Major erosion.problems Yes Q?L <br /> <br />11. <br />Surface movements in valley bottom or on hillside Yes dg) <br /> <br />12. <br />Erosion of toe Yes <br /> <br />13. <br />Water impounded against toe Yes <br /> <br />Yes <br /> <br />No <br />14. Existing embankment freeboard (feet) 1 <br />15. Cracks, bulging, or erosion on upsteam face <br />Yes <br />16. Visible sumps or sinkholes in slurry surface <br />Yes <br />17. Clogging <br /> a) Spillway channels and pipes <br />Yes <br /> b) Decant system <br /> <br />c) Diversion Ditches Yes <br /> <br />18. <br />Cracking or crushing of pipes Yes <br /> a) Spillway pipes <br /> <br />b) Decant system Yes qz?p <br /> <br />19. <br />Trash racks clear and in nlarr Yes mss' <br />-? oY.d 1S 0f F:\Eng\DATA\WP\pond-banks\DAMFORM.wpd <br /> <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