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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: <br />?.„ <br />NPDES ID. No.:CO- 0000213 <br />Date: 6 Tv w ;d. Z G i <br />3 <br />Date Last Inspected: I K ,tfuv� �, lcl3 <br />Facility Configuration: Parcel Incised Pond <br />Site Name: Impoundment #0013 Location:47N16W SEC 36 <br />Mine Name: New Horizon Mine Location:l mi.NW of Nucla, CO. <br />Mine ID No.: CDMG Permit #0008 -81 <br />Owners Rep.: Rick Wolney, Mine Manager <br />F: \ENG\ DATA \WORD \POND- BANKS \DAMFORM.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 V <br />Feet <br />N/A <br />CIRCLE OR WRITE IN APPROPRIATE <br />RESPONSE <br />1. <br />Foundation Preparation (removal of vegetation, stumps., topsoil) Ye <br />No <br />2. <br />Lift thickness (inches) <br />3. <br />Compaction according to approved plan <br />No <br />4. <br />Burning (specify extend and location) <br />Yes <br />(No} <br />5. <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />6. <br />Seepage (specify location, color, and approx. volume) <br />a.) From underdrain pipes: <br />Yes <br />�l9 <br />b.) At isolated points on embankment slopes: <br />Yes <br />c) At natural hillside: <br />Yes <br />i0, <br />d) Over widespread areas <br />Yes <br />(`Ng' <br />e) From downsteam foundation area <br />Yes <br />No) <br />f) "Boils" beneath stream or ponded water <br />Yes <br />No <br />7. <br />Cracks or scarps on crest <br />Yes <br />No <br />8. <br />Cracks or scraps on slope <br />Yes <br />No <br />9. <br />Sloughing or bulging on slope <br />Yes <br />No' <br />10. <br />Mayor erosion problems <br />Yes <br />(N.'' <br />11. <br />Surface movements in valley bottom or on hillside <br />Yes <br />tNo' <br />12. <br />Erosion of toe <br />Yes <br />Nom <br />13. <br />Water impounded against toe <br />Yes <br />Il <br />14. <br />r <br />Existing embankment freeboard (feet) <br />15. <br />Cracks, bulging, or erosion on upsteam face <br />Yes <br />Nod <br />16. <br />Visible sumps or sinkholes in slurry surface <br />Yes <br />(N <br />17. <br />Clogging <br />a) Spillway channels and pipes <br />Yes <br />QN ) <br />b) Decant system <br />Yes <br />No); <br />c) Diversion Ditches <br />Yes <br />18. <br />Cracking or crushing of pipes <br />a) Spillway pipes <br />Yes <br />b) Decant system <br />Yes <br />1No% <br />19. <br />Trash racks clear and in place <br />Ye <br />No <br />F: \ENG\ DATA \WORD \POND- BANKS \DAMFORM.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 V <br />Feet <br />N/A <br />