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F: \Eng \DATA \WP \pond- banks \DAMFORM.wpd <br />Inspectors Name: <br />?0,a c ‘ <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Date: -- 7 N0J Z0(1 <br />NPDES ID. No.:00- 0000213 Date Last Inspected:3I A"gvst 2.51q <br />Facility Configuration: Total Incised Pond <br />Site Name: Impoundment #009 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) C;/ 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 (IN 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 el N/A <br />c) At natural hillside: Yes C4 N/A <br />d) Over widespread areas Yes 0° N/A <br />e) From downsteam foundation area Yes el N/A <br />f) "Boils" beneath stream or ponded water Yes e N/A <br />7. Cracks or scarps on crest Yes 0 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 ® N/A <br />11. Surface movements in valley bottom or on hillside Yes lel N/A <br />12. Erosion of toe Yes CEI1 N/A <br />13. Water impounded against toe Yes ® N/A <br />14 . Existing embankment freeboard (feet) 5G +9 . °� -• S (. 39 _'IS (0 , 53 Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes CEr2 N/A <br />16. Visible sumps or sinkholes in slurry surface Yes N/A <br />17. Clogging <br />a) Spillway channels and pipes Yes N/A <br />b) Decant system Yes at N/A <br />c) Diversion Ditches Yes TN, N/A <br />18. Cracking or crushing of pipes <br />a) Spillway pipes Yes N/A <br />b) Decant system Yes cgD N/A <br />19. Trash racks clear and in place No N/A <br />- 7 Nut) -2-0l( <br />