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3MA2c1%-N i31 ? <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name : ?SS Q-Z,\,??'C, Date: 8 C- \o iO <br />NPDES ID. No.:CO-0000213 Date Last Inspected: -© <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) Q--el- No N/A <br />2. <br />3. <br />4. <br />5. <br />6. <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 />Lift thickness (inches) <br />Compaction according to approved plan 2e. No <br />Burning (specify extend and location) Yes <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />Seepage (specify location, color, and approx. volume) <br />a.) From underdrain pipes: Yes <br />b.) At isolated points on embankment slopes: Yes <br />c) At natural hillside: Yes D- <br />d) over widespread areas Yes (Q <br />e) From downsteam foundation area Yes T <br />f) "Boils" beneath stram or ponded water Yes (o <br />Cracks or scarps on crest Yes 40 <br />Cracks or scraps on slope Yes <br />Sloughing or bulging on slope Yes <br />Major erosion problems Yes 4M2 <br />Surface movements in valley bottom or on hillside Yes Q99 <br />Erosion of toe Yes <br />Water impounded against toe Yes <br />Existing embankment freeboard (feet) cr7l?a ?J° , 5 (1:1 '150 -7 <br />Cracks, bulging, or erosion on upsteam face Yes l;°y° <br />Visible sumps or sinkholes in slurry surface Yes No <br />Clogging <br />a) Spillway channels and pipes Yes <br />b) Decant system Yes <br />c) Diversion Ditches Yes <br />Cracking or crushing of pipes <br />a) Spillway pipes Yes <br />b) Decant system Yes <br />Trash racks clear and in place No <br /> e" . U- ft to ?'rr <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 />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />