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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Dennis Jones DATE: /0 `2 <br />NPDES I.D. NO.: N/A <br />FACILITY CONFIGURATION: Incised Pond DATE LAST INSPECTION: <br />SITE NAME: Truck Wash Settling Pond ** <br />MINE NAME: Peabody Sage Creek Mine <br />MINE I.D. NO.: CDRMS Permit No. C- 2009 -087 <br />Circle or write in appropriate response <br />LOCATION: NWl% NEVI, Sec. 34, T6N, R87W <br />LOCATION: 7.1 mi. SE of Hayden, CO <br />OWNER'S REP.: Ed Brady <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: Yes <br />2. Lift thickness: N/A inches <br />3. Compaction according to approved plan: N/A <br />4. Burning (specify extent and location): N/A <br />5. Angle of slope: upstream, downstream Total = N/A <br />6. *Seepage (specify location, color, and approximate volume) <br />From underdrain pipes: N/A <br />At isolated points on embankment slopes: N/A <br />At natural hillside: N/A <br />Over widespread areas: N/A <br />From downstream foundation area: N/A <br />"Boils" beneath stream or ponded water: Yes ( Na N/A <br />7. Cracks or scarps on crest: N/A <br />8. Cracks or scarps on slope: N/A <br />9. Sloughing or bulging on slope: N/A <br />10. *Major erosion problems: Yes (No) N/A <br />11. Surface movements in valley bottom or on hillside: N/A <br />12. *Erosion of toe: N/A <br />13. *Water impounded against toe: N/A <br />14. Existing embankment freeboard: (normal = 5 . 0 ' ) (1 R / feet <br />15. Increase Decrease in water level: feet <br />16. Cracks, bulging, or erosion on upstream face: <br />17. Visible sumps or sinkholes in slurry surface: <br />18. *Clogging <br />Spillway channels and pipes: Yes (No\ N/A <br />Decant system: N/A <br />Diversion ditches: N/A <br />19. *Cracking or crushing of pipes <br />Spillway pipes: Yes 6) N/A <br />Decant system: N/A <br />20. Trash racks clear and in place: 'r No N/A <br />21. Discharge rate (gpm) <br />* *This pond serves as a fuel spill containment pond now. <br />N/A <br />N/A <br />O <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 <br />in these items should normally be described (extent, location, volume, etc.) in the space on <br />the back of this sheet. <br />