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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: _ Dennis Jones <br />NPDES I.D. NO.: N/A <br />FACILITY CONFIGURATION: Incised Pond <br />SITE NAME: Truck Wash Settling Pond <br />MINE NAME: Peabody Sage Creek Mine <br />MINE I.D. NO.: CDRMS Permit No. C-2009-087 <br />V <br />DATE : 10-13-1 <br />DATE LAST INSPECTION: 9-9-1-0- <br />LOCATION: NWl/, NE%, Sec. 34, T6N, R87W <br />LOCATION: 7.1 mi. SE of Hayden, CO <br />OWNER'S REP.: Mike Ludlow <br />Circle or write in appropriate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: Yes <br />2. Lift thickness: N/A inches <br />3. Compaction according to approved plan: N/A <br />4. Burning (specify extent and location): N/A <br />5. Angle of slope: upstream, downstream Total = N/A <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes: N/A <br /> At isolated points on embankment slopes: N/A <br /> At natural hillside: N/A <br /> Over widespread areas: N/A <br /> From downstream foundation area: N/A <br /> "Boils" beneath stream or ponded water: Yes (2D N/A <br />7. Cracks or scarps on crest: N/A <br />8. Cracks or scarps on slope: N/A <br />9. Sloughing or bulging on slope: N/A <br />10. *Major erosion problems: Yes (o N/A <br />11. Surface movements in valley bottom or on hillside: N/A <br />12. *Erosion of toe: N/A <br />13. *Water impounded against toe: N/A <br />14. Existing embankment freeboard: (normal = 5.01) Q feet <br />15. Increase Decrease in water level: feet <br />16. Cracks, bulging, or erosion on upstream face: N/A <br />17. Visible sumps or sinkholes in slurry surface: N/A <br />18. *Clogging <br />Y <br />Z o <br /> Spillway channels and pipes: es ( <br />) <br /> Decant system: N/A <br /> Diversion ditches: N/A <br />19. *Cracking or crushing of pipes <br />Y <br />©o N/A <br /> Spillway pipes: es <br /> Decant system: N/A <br />20. Trash racks clear and in place: No N/A <br />21. Discharge rate (gpm) <br />*Major adverse changes in these items could cause instability and should be reported to the <br />Engineering Manager and Mine Superintendent for further evaluation. Adverse conditions noted <br />in these items should normally be described (extent, location, volume, etc.) in the space on <br />the back of this sheet.