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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br /> <br />Inspectors Name Date: 6 ?,c,-6 zca 1 G <br />Mine ID No.: CDMG Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manager <br />NPDES ID. No.:CO-0000213 Date Last Inspected: W -/e. Oct <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 /> 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 No <br />4. Burning (specify extend and location) Yes 0- <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 do' <br /> b.) At isolated points on embankment slopes: Yes & <br /> c) At natural hillside: Yes 0V <br /> d) over widespread areas Yes <br /> e) From downsteam foundation area Yes <br /> f) "Boils" beneath stram or ponded water Yes d9p <br />7. Cracks or scarps on crest Yes PEp <br />8. Cracks or scraps on slope Yes '0 <br />9. Sloughing or bulging on slope Yes 0 <br />10. Major erosion problems Yes 0 <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),5? ¢9 9 - 64-z-, 7 <br />-7 <br />z- <br />15. Cracks, bulging, or erosion on upsteam face Yes Az? <br />16. visible sumps or sinkholes in slurry surface Yes <br />17. Clogging <br /> a) Spillway channels and pipes Yes dIP <br /> b) Decant system Yes <br /> C) Diversion Ditches Yes OD <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes <br /> b) Decant system Yes <br />19.. Trash racks cleat <br />and in place Ye No <br />1 / <br />1 <br /> c <br />?vo/?Lc ?? hof?6.yc. c <br />o??.? <br />? <br /> <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 />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 />S Fem.. b zs) 10