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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: 1.J ­-,-, Ra, /6- Date: �- <br />NPDES ID. No.:CO- 0000213 Date Last Inspected <br />Facility Configuration: Total Incised Pond <br />Site Name: Impoundment #008 <br />Mine Name: New Horizon Mine <br />Location:46N15W SEC 6 <br />Location:l mi.NW of Nucla, CO. <br />Mine ID No.. CDMG Permit #0008 -81 <br />Owners Rep.: Rick Wolney, Mine Manager <br />1 <br />2 <br />3 <br />4 <br />5 <br />6 <br />7. <br />8. <br />9. <br />10 <br />11 <br />12 <br />13 <br />14 <br />15 <br />16 <br />17 <br />18 <br />19 <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />Foundation Preparation (removal of vegetation, stumps., topsoil) Yes No <br />Lift thickness (inches) <br />Compaction according to approved plan <br />Ye rs <br />No <br />Burning (specify extend and location) <br />Yes <br />lNo <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />Seepage (specify location, color, and approx. volume) <br />Nor <br />a.) From underdrain pipes: <br />Yes <br />b.) At isolated points on embankment slopes: <br />Yes <br />No) <br />C) At natural hillside: <br />Yes <br />N <br />d) Over widespread areas <br />Yes <br />No <br />e) From downsteam foundation area <br />Yes <br />) <br />f) "Boils" beneath stream or ponded water <br />Yes <br />koo � <br />Cracks or scarps on crest <br />Yes <br />No`' <br />Cracks or scraps on slope <br />Yes <br />No <br />Sloughing or bulging on slope <br />Yes <br />No <br />Major erosion problems <br />Yes <br />No <br />Surface movements in valley bottom or on hillside <br />Yes <br />Noy <br />Erosion of toe <br />Yes <br />�No� <br />Water impounded against toe <br />Yes <br />No <br />Existing embankment freeboard (feet) )�(��. <br />Cracks, bulging, or erosion on upsteam face <br />Yes <br />Goo <br />Visible sumps or sinkholes in slurry surface <br />Yes <br />CIO) <br />Clogging C-L1'r C r <t >"- 1:3 ^� <br />�r pwt(� v <br />/) <br />a) Spillway channels and pipes fViev,a )- vfw S <br />f <br />Yes <br />k, No <br />b) Decant system <br />Yeso <br />c) Diversion Ditches <br />Yes <br />No <br />Cracking or crushing of pipes <br />a) Sp; 11 way pipes <br />Yes <br />(, <br />b) Decant system <br />Yes <br />No <br />Trash racks clear and in place <br />'Yes`' <br />No <br />F: \ENG\ DATA \WORD \POND - BANKS \DAMFORiM.DOCDOC <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />Feet <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />