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NPDES ID. No.:CO- 0000213 <br />1 I ,J n0 015di. r i n csx.— <br />F: \Eng \DATA \WP \pond- banks \DAMFORM. <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: �, �So�Kc Date: `4 1 Zns _ <br />Date Last Inspected: 7 14ov 11 <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 CCD No N/A <br />4 Burning (specify extend and location) Yes • 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 CP N/A <br />b.) At isolated points on embankment slopes: Yes ® N/A <br />c) At natural hillside: Yes CD N/A <br />d) Over widespread areas Yes <E2 N/A <br />e) From downsteam foundation area Yes OD N/A <br />f) "Boils" beneath stream or ponded water Yes ® N/A <br />7. Cracks or scarps on crest Yes (D 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 ® N/A <br />12. Erosion of toe Yes ® N/A <br />13. Water impounded against toe Yes (D N/A <br />14. Existing embankment freeboard (feet) ,Vp513, 25 — 5`4a , 1 /O. . Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes AOP N/A <br />16. Visible sumps or sinkholes in slurry surface Yes 400 N/A <br />17. Clogging <br />a) Spillway channels and pipes Yes GST N/A <br />b) Decant system Yes N/A <br />c) Diversion Ditches Yes ® N/A <br />18. Cracking or crushing of pipes <br />a) Spillway pipes Yes calt N/A <br />b) Decant system Yes ® N/A <br />19. Trash racks clear and in place No N/A <br />