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Inspectors Name: (v <br />NPDES ID. No.:CO- 0000213 <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />19. Trash racks clear and in place <br />F: \ENG\ DATA \WORD \POND- BANKS \DAMFORM.DOCDOC <br />Date: (440 - 1, )..013 <br />Date Last Inspected: 13d/ y vJZ <br />Facility Configuration: Parcel Incised Pond <br />Site Name: Impoundment #011 Location:46N16W SEC 1 <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 />No N/A <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) <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 N/A <br />b.) At isolated points on embankment slopes: Yes 6 N/A <br />c) At natural hillside: Yes 10 N/A <br />d) Over widespread areas Yes a N/A <br />e) From downsteam foundation area Yes 6 N/A <br />f) "Boils" beneath stream or ponded water Yes 4D N/A <br />7. Cracks or scarps on crest Yes No 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 0 N/A <br />11. Surface movements in valley bottom or on hillside Yes o N/A <br />12. Erosion of toe Yes N/A <br />13. Water impounded against toe Yes 6; 14. 14. Existing embankment freeboard (feet) 3,1-7- 1. ILO Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes 6) N/A <br />16. Visible sumps or sinkholes in slurry surface Yes 6) N/A <br />17. Clogging <br />a) Spillway channels and pipes Yes N) N/A <br />b) Decant system Yes ® N/A <br />c) Diversion Ditches Yes 0 N/A <br />Yes <br />18. Cracking or crushing of pipes <br />a) Spillway pipes Yes <br />b) Decant system Yes <br />No N/A <br />N/A <br />N/A <br />N/A <br />