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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name : 4,55 (7-=PU?ok Date: 4-1 qz 20 l o <br />NPDES ID. No.:CO-0000213 Date Last Inspected: Q A;?-d (p <br />Facility Configuration: Parcel Incised Pond <br />Site Name: Impoundment #0013 Location:47N16W SEC 36 <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) Ye No N/A <br />2. Lift thickness (inches) <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 />Compaction according to approved plan <br /> <br />Burning (specify extend and location) Ye <br /> <br />Yes No <br /> <br />CIO <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 (iD <br />c) At natural hillside: <br />Yes <br />d) Over widespread areas <br />Yes <br />e) From downsteam foundation area <br />Yes QV <br />f) "Boils" beneath stram or ponded water <br /> <br />C <br />Yes <br />racks or scarps on crest Yes <br />Cracks or scraps on slope <br />Sl Yes <br />oughing or bulging on slope <br /> <br />Major erosion problems Yes <br /> <br />Surface movements in valley bottom or on hillside Yes <br /> <br />Yes <br />Erosion of toe <br /> <br />Water impounded against toe Yes <br /> <br />Yes CIP <br /> <br />N? <br />Existing embankment freeboard (feet)_. <br />Cracks, bulging, or erosion on upsteam face <br /> <br />Vi <br />i / G <br />Yes <br />s <br />ble sumps or sinkholes in slurry surface <br />Yes <br />Clogging <br />a) Spillway channels and pipes <br /> <br />b) <br />Yes <br />Decant system <br /> <br />c) Diversion Ditches Yes <br /> <br />Cracking or crushing of pipes Yes <br />a) Spillway pipes Yes G?w <br />b) Decant system <br /> <br />Trash racks clear and in place- Yes <br /><--7) <br />- <br />I- <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 />l `f Zc9 , v