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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Dennis Jones DATE: 6 -15 1 D <br />NPDES I.D. NO.: N/A <br />FACILITY CONFIGURATION: Incised Pond <br />SITE NAME: Truck Wash Settling Pond <br />MINE NAME: Seneca II Mine (Seneca Coal Co) <br />MINE I.D. NO.: CDMG Permit No. C-80-005 <br />DATE LAST INSPECTION: :? .a tl - oci <br />LOCATION: NW1/ NEV/, Sec. 34, T6N, R87W <br />LOCATION: 7.1 mi. SE of Hayden CO <br />OWNER'S REP.: Roy Karo, Gen Mar <br />Circle or write in a proyriate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: Yes <br />2. Lift thickness: N/A inches <br />3. Compaction according to approved plan: N/A <br />4. Burning (specify extent and location): N/A <br />5. Angle of slope: upstream, downstream Total = N/A <br />6. *Seepage (specify location, color, and approximate volume) <br />7. <br />8. <br />9. <br />10. <br />11. <br />12. <br />13. <br />14. <br />15. <br />16. <br />17. <br />18. <br />19 <br />20. <br />21. <br />From underdrain pipes: <br />At isolated points on embankment slopes: <br />At natural hillside: <br />Over widespread areas: <br />From downstream foundation area: <br />"Boils" beneath stream or ponded water: <br />Cracks or scarps on crest: <br />Cracks or scarps on slope: <br />Sloughing or bulging on slope: <br />*Major erosion problems: <br />Surface movements in valley bottom or on hillside: <br />*Erosion of toe: <br />*Water impounded against toe: <br />Existing embankment freeboard: (normal = 5.01) <br />Increase Decrease in water level: <br />Cracks, bulging, or erosion on upstream face: <br />Visible sumps or sinkholes in slurry surface: <br />*Clogging <br />Spillway channels and pipes: <br />Decant system: <br />Diversion ditches: <br />*Cracking or crushing of pipes <br />Spillway pipes: <br />Decant system: <br />Trash racks clear and in place: <br />Discharge rate (gpm) W4dQ-A KO-1 3 end Q to L..) ;S 4Vy? <br />NLA <br />N/A <br />N/A <br />N/A <br />N/A <br />Yes No <br />N/A <br />N/A <br />N/A <br />Yes No <br />N/A <br />N/A <br />N/A <br />_ feet <br />feet <br />N/A <br />N/A <br />N/A <br />N/A <br />Yes No N/A <br />N/A <br />N/A <br />Yes No N/A <br />N/A <br />No N/A <br />*Major adverse changes in these items could cause instability and should be reported to the <br />Engineering Manager and Mine Superintendent for further evaluation. Adverse conditions noted <br />in these items should normally be described (extent, location, volume, etc.) in the space on <br />the back of this sheet. <br />? f ( x. l 4'?C, q w? ---, 0 L-k k .