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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: TV�IJ2 V'�Y'- �e% Date: Z '7 G <br />0) <br />NPDES <br />ID. NO.:COG- 850062 Date Last Inspected: <br />Z(9)3 <br />Facility <br />Configuration: Partial Incised Pond <br />Site <br />Name: NHN Impoundment #001A Location:SEC <br />25, 47N 16W <br />Mine <br />Name: New Horizon North Mine Location:2.4 <br />mi.NW <br />of Nucla, <br />CO. <br />Mine ID No.: CDMG Permit: C- 2010 -089 <br />Owners <br />Rep.: Rick Wolney, Mine Manager <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. <br />Foundation Preparation (removal of vegetation, stumps., topsoil) <br />(Y- es <br />No <br />N/A <br />2. <br />Lift thickness (inches) 1 0, 7 <br />3. <br />Compaction according to approved plan <br />Yes <br />No <br />N/A <br />4. <br />Burning (specify extend and location ) <br />Yes <br />No <br />N/A <br />5. <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />6. <br />Seepage (specify location, color, and appr= . volume) <br />a.) From underdrain pipes: <br />Yes <br />N/A <br />b.) At isolated points on embankment slopes: <br />Yes <br />N/A <br />c) At natural hillside: <br />Yes <br />N/A <br />d) over widespread areas <br />Yes <br />No <br />N/A <br />e) From downsteam foundation area <br />Yes <br />N/A <br />f) "Boils" beneath stream or ponded water <br />Yes <br />No <br />N/A <br />7. <br />Cracks or scarps on crest <br />Yes <br />No <br />N/A <br />8. <br />Cracks or scraps on slope <br />Yes <br />No <br />N/A <br />9. <br />Sloughing or bulging on slope <br />Yes <br /><Do <br />N/A <br />10. <br />Mayor erosion problems <br />Yes <br />& <br />N/A <br />11. <br />Surface movements in valley bottom or on hillside <br />Yes <br />N <br />N/A <br />12. <br />Erosion of toe <br />Yes <br />No <br />N/A <br />13. <br />Water impounded against toe <br />Yes <br />N/A <br />14. <br />E::isting embankment freeboard (feet) 7 I• ) r s�p�i S .� <br />37 <br />Feet <br />15. <br />Cracks, bulging, or erosion on upsteam face <br />Yes <br />No <br />N/A <br />16. <br />visible sumps or sinkholes in slurry surface <br />Yes <br />N <br />N/A <br />17. <br />Clogging <br />a) Spillway channels and pipes <br />Yes <br />1ll <br />N/A <br />b) Decant system <br />Yes <br />N/A <br />c) Diversion Ditches <br />Yes <br />N <br />N/A <br />18. <br />Cracking or crushing of pipes <br />a) Spillway pipes <br />Yes <br />No <br />N/A <br />b) Decant system <br />Yes <br />® <br />N/A <br />lu. <br />Trash racks clear and in place <br />es' <br />No <br />1� /A <br />�0 Kj )5 pi-� <br />G:\ DATA \WP \pond- banks \DAMFOP.M.wpd <br />