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"Po, , ` 5arc. <br />F: \Eng \DATA \WP \pond - banks \DAMFORM.wpd <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: l� (;;■Ooka, Date: 3\ .A.,...v.s-- '�1\ <br />NPDES ID. No.:CO - 0000213 Date Last Inspected: Z Q,, <br />Facility Configuration: Parcel Incised Pond <br />Site Name: Impoundment #0013 Location:47N16W SEC 36 <br />Mine Name: New Horizon Mine Location:1 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) e> No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan Ye No N/A <br />4. Burning (specify extend and location) Yes MY N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br />a.) From underdrain pipes: Yes ® N/A <br />b.) At isolated points on embankment slopes: Yes ® N/A <br />c) At natural hillside: Yes ® N/A <br />d) Over widespread areas Yes 4E1 N/A <br />e) From downsteam foundation area Yes ® N/A <br />f) "Boils" beneath stream or ponded water Yes N/A <br />7. Cracks or scarps on crest Yes 0.14 N/A <br />8. Cracks or scraps on slope Yes N/A <br />9. Sloughing or bulging on slope Yes N/A <br />10. Major erosion problems Yes OD 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 <br />14. Existing embankment freeboard (feet) 55 / - -OrS'Z_ . '7, Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes 4ga N/A <br />16. Visible sumps or sinkholes in slurry surface Yes C303 N/A <br />17. Clogging <br />a) Spillway channels and pipes <br />b) Decant system <br />Yes Cal <br />Yes ®j <br />N/A <br />N/A <br />N/A <br />c) Diversion Ditches Yes c7DP. <br />18. Cracking or crushing of pipes <br />a) Spillway pipes Yes N/A <br />b) Decant system Yes N/A <br />19. Trash racks clear and in place 0 No N/A <br />