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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />inspectors <br />Name: ROSS C.u�4\C', Date: <br />J3 tau v - L%DkL- <br />NPDES <br />ID. No. :CO-0000213 Date <br />Last inspected: <br />�ei� zollr-- <br />Facility <br />Coniiquration:Incised Pond <br />Site <br />Name: Impoundment #012 Location:47N16W <br />Sec <br />36 <br />Mine <br />Name: New Horizon Mine Location:2 <br />mi.NW of <br />Nucla, <br />CO. <br />Mine <br />ID No.: CDMG Permit 40008 -81 <br />Owners Rep.: R. L. Wade, Mine Manager <br />CIRCLE OR WRITE IN APPROPRIATE <br />RESPONSE <br />1 <br />Foundation Preparation (removal of vegetation, stumps., topsoil) jes <br />No <br />TT /A <br />Lift thickness (inches) <br />3- <br />Compaction according to apuroved Ulan <br />t®s <br />?To <br />N/A <br />4 <br />Burling (specify e_ -_tend and location) <br />ies <br />Tr <br />N/A <br />5. <br />Angle of slope: :1 upstream, 3:1 downstream <br />6 <br />Seepage (specify location, color, or, and appro__. - olume) <br />a ) From underdrain pipes: <br />Yes <br />Q'� <br />N/A <br />1). f At lsolaLCd points un eiltbankment slopes: <br />ies <br />© <br />is /A <br />c) At natural hillside- <br />Yes <br />® <br />N/A <br />d) over widespread areas <br />Yes <br />N/A <br />e) From downsteam foundation area <br />Yes <br />v® <br />iv /A <br />f) "Boils" beneath scream or ponded water <br />Yes <br />N/A <br />7 <br />Cracks or scarps on crest <br />Yes <br />® <br />N/A <br />3. <br />Cracks or scraps on slope <br />Yes <br />N/A <br />9 <br />Sloughing or bulging on slope <br />Yes <br />N/A <br />10 <br />Majoi erosion problems -- <br />- -_ - -- Yes <br />QP <br />N/A <br />11 <br />Surface movements in valley bottom or on hillside <br />Yes <br />N/A <br />13 <br />Erosion of toe <br />Yes <br />N/A <br />13. <br />Water impounded against toe <br />Yess <br />N!A <br />14. <br />E__isting embankment freeboard (feet) 5(OQ"], 3� 559%, <br />S i S <br />Feet <br />15 <br />Cracks, bulging, or erosion on upsteam face <br />Yes <br />® <br />N/A <br />15 <br />Visible sumps or sinkholes in slurry surface <br />_ Yes <br />Q <br />N/A <br />17 <br />Clogging <br />a) Spill-,;,ay channels and pipes <br />Yes <br />N/A <br />ID) Decant syste«i <br />ics <br />Di /A <br />c) Diversion Dicches <br />ie <br /><0 <br />N/A <br />12 <br />Cracking or crushing of pipes <br />a) Spill;,ay pipes <br />Fes <br />N/A <br />b) Decant system <br />ies <br />0:1 <br />N/A <br />15 <br />T---ash racks clear and in place <br />G) <br />No <br />N/A <br />ri• i <br />J3 No v9 `zs' �--- <br />