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INSPECTOR'S NAME: Dennis Jones <br />FACILITY CONFIGURATION: Diked Pond <br />SITE NAME: Upper Sump <br />MINE NAME: Peabody Sage Creek Mine <br />MINE I.D. NO.: CDRMS Permit No. C- 2009 -087 <br />PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />DATE: H-9-11 C ( 54 / 1 <br />DATE LAST INSPECTION: <br />Circle or write in appropriate response <br />LOCATION: NWW, Sec. 3, T5N, R87W <br />LOCATION: 7.1 mi. SE of Hayden, CO <br />OWNER'S REP.: Mike Ludlow <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: Yes <br />2. Lift thickness: <br />3. Compaction according to approved plan: <br />4. Burning (specify extent and location): <br />5. Angle of slope: upstream, downstream Total = <br />6. *Seepage (specify location, color, and approximate volume) <br />From underdrain pipes: N/A <br />At isolated points on embankment slopes: Yes (N)<) <br />At natural hillside: Yes /VOA N/A <br />Over widespread areas: Yes No N/A <br />From downstream foundation area: Yes No N/A <br />"Boils" beneath stream or ponded water: Yes No N/A <br />7. Cracks or scarps on crest: Yes No N/A <br />8. Cracks or scarps on slope: Yes No N/A <br />9. Sloughing or bulging on slope: Yes No N/A <br />10. *Major erosion problems: Yes No N/A <br />11. Surface movements in valley bottom or on hillside: Yes No N/A <br />12. *Erosion of toe: Yes No N/A <br />13. *Water impounded against toe: Yes ` No d N/A <br />14. Existing embankment freeboard: c%.r.f CJeS,k oA a - 7'$ feet <br />15. Increase Decrease in water level: 4A feet <br />16. Cracks, bulging, G N/A <br />g, or erosion on upstream face: Yes No- N A <br />17. Visible sumps or sinkholes in slurry surface: N/A <br />18. *Clogging <br />Spillway channels and pipes: Yes No N/A <br />Decant system: N/A <br />Diversion ditches: Yes No N/A <br />19. *Cracking or crushing of pipes <br />Spillway pipes: Yes NS N/A <br />Decant system: N/A <br />20. Trash racks clear and in place: Ye No N/A <br />21. Discharge rate (gpm) Q <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 />in. <br />Yes <br />No <br />