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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: ( K,Ldl/✓' �GI`JGIa�� Date: �7 �u� Z )/3 <br />NPDES ID. NO.: CO- 0000213 Date Last Inspected: 2 J �uk"- Zol a <br />Facility Configuration: Total Incised Pond <br />Site Name: Impoundment #009 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 />1 <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 N/A <br />Lift thickness (inches) <br />Compaction according to approved plan <br />Burning (specify extend and location) <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />Seepage (specify location, color, and approa. volume) <br />a.) From underdrarn pipes: <br />b.) At isolated points on embankment slopes: <br />c) At natural hillside: <br />d) Over widespread areas <br />e) From downsteam foundation area <br />f) "Boils" beneath stream or ponded water <br />Cracks or scarps on crest <br />Cracks or scraps on slope <br />Sloughing or bulging on slope <br />Mayor erosion problems <br />Surface movements in valley bottom or on hillside <br />Erosion of toe <br />Water impounded against toe <br />E: =Ts ing emban}:ment freeboard (feet) h "13- <br />Cracks, bulging, or erosion on upsteam face <br />Visible sumps or sinkholes in slurry surface <br />Clogging <br />a) Spillway channels and pipes <br />b) Decant system <br />c) Diversion Ditches <br />Cracking or crushing of pipes <br />a Spillway pipes <br />b) Decant system <br />Trash -racks clear and in place <br />:1 <br />1 � <br />G: \DATA \WP \pond - ban}= s \DAMFORM.doc <br />Yes No N/A <br />Yes �q N/A <br />Yes <br />N <br />N/A <br />Yes <br />N/A <br />Yes <br />// <br />N/A <br />Yes <br />N/A <br />Yes <br />N/A <br />Yes <br />No <br />N/A <br />Yes <br />No <br />N/A <br />Yes <br />No <br />N/A <br />Yes <br />N <br />N/A <br />Yes <br />tIo <br />N/A <br />Yes <br />N� <br />N/A <br />Yes <br />No <br />N/A <br />Yyes <br />N/A <br />F <br />Feet <br />Yes <br />No <br />N/A <br />Yes <br />�Do <br />N/A <br />Yes <br />No <br />N/A <br />Yes <br />No <br />N/A <br />Yes <br />No <br />N/A <br />Yes <br />N <br />N/A <br />Yes <br />N <br />N/A <br />ies <br />No <br />N/A <br />•Z45 1p..�c,SvtS \ Z,o43 <br />