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<br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name : l zs5 e-11.010? <br />NPDES ID. No.:CO-0000213 <br />Date: 1o A"g"gA Z-C? t-0 <br />Date Last Inspected: A-lnA r Zo-to <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 />Mine ID No.: CDMG Permit 40008-81 <br />Owners Rep.: R. L. Wade, Mine Manager <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />No N/A <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) <0 <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 />TGC.0- OIQ <br />F:\Eng\DATA\WP\pond-banks\DAMFORM.wpd <br />Lift thickness (inches) <br />Compaction according to approved plan 4 0 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 <br />d) over widespread areas Yes Gb <br />e) From downsteam foundation area Yes <br />f) "Boils" beneath stram or ponded water Yes cm <br />Cracks or scarps on crest Yes <br />Cracks or scraps on slope Yes cz? <br />Sloughing or bulging on slope Yes <br />Major erosion problems Yes d9 <br />Surface movements in valley bottom or on hillside Yes <br />Erosion of toe Yes <br />Water impounded against toe Yes <br />Existing embankment freeboard (feet)SL 49 . Ck 0,03 <br />Cracks, bulging, or erosion on upsteam face Yes <br />Visible sumps or sinkholes in slurry surface Yes <br />Clogging <br />a) Spillway channels and pipes Yes <br />b) Decant system Yes No <br />c) Diversion Ditches Yes <br />Cracking or crushing of pipes <br />a) Spillway pipes Yes ®N <br />b) Decant system Yes <br />Trash racks cleat and in place Ye <br />\,J e A-- s i^ NoxAOM, ?y4,?i <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 />