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� r <br />Inspectors Name: I..,,oi ! Date: ( �I /,y <br />At( ,1 203 <br />NPDES ID. No.:00- 0000213 <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.: Rick Wolney, Mine Manager <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) (Yesj No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan <br />4. Burning (specify extend and location) <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 No N/A <br />b.) At isolated points on embankment slopes: Yes No N/A <br />c) At natural hillside: Yes Vc N/A <br />d) Over widespread areas Yes No N/A <br />e) From downsteam foundation area Yes ® N/A <br />f) "Boils" beneath stream or ponded water Yes N/A <br />7. Cracks or scarps on crest Yes Io N/A <br />8. Cracks or scraps on slope Yes N) N/A <br />9. Sloughing or bulging on slope Yes ? N/A <br />L� 7 <br />10. Major erosion problems Yes N/A <br />11. Surface movements in valley bottom or on hillside Yes Q> N/A <br />12. Erosion of toe Yes e N/A <br />13. Water impounded against toe Yes ciD. N/A <br />14. Existing embankment freeboard (feet) �Q +� ',�� l,�t'7 Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes 6) N/A <br />16. Visible sumps or sinkholes in slurry surface Yes No N/A <br />17. Clogging <br />a) <br />b) <br />c) <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Yes T N/A <br />Decant system Yes N/A <br />Spillway channels and pipes <br />Diversion Ditches <br />18. Cracking or crushing of pipes <br />a) Spillway pipes Yes No <br />b) Decant system Yes <br />F: \ENG\ DATA \WORD \POND- BANKS \DAMFORM.DOCDOC <br />PERIODIC INSPECTION FORM <br />19. Trash racks clear and in place Yes <br />Date Last Inspected: V 3 4 6 / 2d).2 <br />No N/A <br />Yes N/A <br />Yes 1 N/A <br />`Zo s" ACL -13 <br />