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<br />j`rt'3 o lb-.,A 7 ./y 1 C-kjo v <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br /> <br />Date: & ?..$ \ -W <Q <br />Date Last Inspected: k\-- 3 Oq <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 />Inspectors Name : 0,,5:!s <br />NPDES ID. No.:CO-0000213 <br />Mine ID No.: CDMG Permit #0008-81 <br />Owne rs Rep.: R. L. Wade, Mine Manager <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 ge No <br />4. Burning (specify extend and location) Yes No <br />S. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) From underdrain pipes: Yes 01 <br /> b.) At isolated points on embankment slopes: Yes <br /> c) At natural hillside: Yes CNc <br /> d) Over widespread areas Yes C? <br /> e) From downsteam foundation area Yes CZ1o„_, <br /> f) "Boils" beneath stram or ponded water Yes <br />7. Cracks or scarps on crest Yes <br />8. Cracks or scraps on slope Yes ?No <br />9. Sloughing or bulging on slope Yes <br />10. major erosion problems Yes 70 <br />11. Surface movements in valley bottom or on hillside Yes <br />12. Erosion of toe Yes No <br />13. Water impounded against toe Yes lzJ <br />14. Existing embankment freeboard (feet)A-1?T rJ?+Z-e -7,b <br />15. Cracks, bulging, or erosion on upsteam face Yes 10 <br />16. Visible sumps or sinkholes in slurry surface Yes <0) <br />17. Clogging <br /> a) Spillway channels and pipes Yes <br /> b) Decant system Yes (Nc <br /> c) Diversion Ditches Yes <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes <br /> b) Decant system Yes <br />19. Trash racks cleat and in place Yes No <br /> , <br /> <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 />?.?2 (1 t Zla \