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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: _ Dennis Jones DATE: I II- Z 16) <br />NPDES I.D. NO.: CO-0048275 D.P. 003 <br />FACILITY CONFIGURATION: Diked Pond <br />SITE NAME: Northwest Impoundment #003 <br />MINE NAME: Peabody Sage Creek Mine <br />MINE I.D. NO.: CDRMS Permit No. C-2009-087 <br />DATE LAST INSPECTION: [-tS'` 16 <br />LOCATION: SE1/ SWl/,, Sec. 27, 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: 12 in. <br />3. Compaction according to approved plan: Yes <br />4. Burning (specify extent and location): No <br />5. Angle of slope: 2:1 upstream, 3:1 downstream Total = 5:1 <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes: N/A <br /> At isolated points on embankment slopes: Yes N/A <br /> At natural hillside: Yes N/A <br /> Over widespread areas: Yes N/A <br /> From downstream foundation area: Yes N/A <br /> "Boils" beneath stream or ponded water: Yes N/A <br />7. Cracks or scarps on crest: Yes N/A <br />8. Cracks or scarps on slope: Yes l N/A <br />9. Sloughing or bulging on slope: Yes N/A <br />10. *Major erosion problems: Yes N/A <br />11. Surface movements in valley bottom or on hillside: Yes N/A <br />12. *Erosion of toe: Yes N/A <br />13. *Water impounded against toe: Yes N/A <br /> <br />14. <br />Existing embankment freeboard: (normal = 4.91) <br />?? eet <br />15. Increase Decrease in water level: ?/1,u c (nc?kw? feet <br />16. Cracks, bulging, or erosion on upstream face: Yes No N/A <br />17. Visible sumps or sinkholes in slurry surface: N/A <br />18. *Clogging <br />? <br /> Spillway channels and pipes: Yes N/A <br /> Decant system: N/A <br /> Diversion ditches: Yes CN) N/A <br />19. *Cracking or crushing of pipes <br /> <br />Spillway pipes: <br />Yes ?1 <br />Do <br />N/A <br /> Decant system: N/A <br />20. Trash racks clear and in place: Yes 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 in <br />these items should normally be described (extent, location, volume, etc.) in the space on the <br />back of this sheet. <br />? Q <br />U` V?- r a L,)s 0 -10 -0 0 e-CC ??c>