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Inspectors Name: 10.55 Gv, Date: I N o tJ Zoo 1 l <br />NPDES ID. No.:CO - 0000213 Date Last Inspected: 31 A„_ z,t1 <br />Facility Configuration: Total Incised Pond <br />Site Name: Impoundment #008 Location:46N15W SEC 6 <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) es No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan ED No N/A <br />4. Burning (specify extend and location) Yes No 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 0 N/A <br />b.) At isolated points on embankment slopes: Yes ®o N/A <br />c) At natural hillside: Yes ® N/A <br />d) Over widespread areas Yes 0 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 <br />®, N/A <br />8. Cracks or scraps on slope Yes ® N/A <br />9. Sloughing or bulging on slope Yes <br />N/A <br />10. Major erosion problems Yes ® N/A <br />11. Surface movements in valley bottom or on hillside Yes CD N/A <br />12. Erosion of toe Yes aZ N/A <br />13. Water impounded against toe Yes V N/A <br />14. Existing embankment freeboard (feet) 51.511 .3 -5001,5 8.a Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes a N/A <br />16. Visible sumps or sinkholes in slurry surface Yes ® N/A <br />17. Clogging <br />a) Spillway channels and pipes <br />b) Decant system <br />c) Diversion Ditches <br />18. Cracking or crushing of pipes <br />a) Spillway pipes Yes <br />b) Decant system Yes <br />19. Trash racks clear and in place <br />or, <br />F: \Eng \DATA \WP \pond- banks \DAMFORM.wpd <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Yes <br />Yes <br />Yes <br />No <br />/Not/ <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />