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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: & �UtIJ2- Date: Ati 2-013 <br />NPDES ID. NO.:CO- 0000213 Date Last Inspected: 2a ,hike- 2-613 <br />Facility Configuration: Parcel Incised Pond <br />Site Name: Impoundment #011 Location:46N16W SEC 1 <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 />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) Yes No N/A <br />— <br />Lift Lift thickness (inches) <br />3. <br />Compaction according to approved plan <br />e� <br />No <br />N/A <br />4. <br />Burning (specify e::tend and location) <br />Yes <br />No <br />N/A <br />5. <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />h. <br />Seepage (specify location, color, and appro::. volume) <br />a.) From underdrain pipes: <br />Yes <br />No <br />N/A <br />b.) At isolated points on embankment slopes: <br />Yes <br />No <br />N/A <br />c) At natural hillside: <br />Yes <br />No <br />N/A <br />d) Over widespread areas <br />Yes <br />E <br />N/A <br />e) From downsteam foundation area <br />Yes <br />No <br />N/A <br />f) "Boils" beneath stream or ponded water <br />Yes <br />Nozz <br />N/A <br />7. <br />Cracks or scarps on crest <br />Yeso) <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 />N{ <br />N/A <br />10. <br />Major erosion problems <br />Yes <br />N/A <br />11. <br />Surface movements in valley bottom or on hillside <br />Yes <br />ido <br />N/A <br />13. <br />Erosion of toe <br />Yes <br />No <br />N/A <br />13. <br />Plater impounded against toe <br />Yes <br />N/A <br />14. <br />E::istrng embankment freeboard (feet) <br />10-1 <br />Feet <br />15. <br />Cracks, bulging, or erosion on upsteam face <br />Yes <br />Jo <br />N/A <br />lb. <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 />No <br />N/A <br />b) Decant system <br />Yes <br />I <br />N/A <br />c) Diversion Ditches <br />Yes <br />No <br />N/A <br />18. <br />Cracking or crushing of pipes <br />a) Spillway pipes <br />Yes <br />N/A <br />b) Decant system <br />Yes <br />N /A_ <br />la. <br />Trash racks clear and in place <br />ies' <br />No <br />N/A <br />1 <br />G: \DATA \WP \pond- banks \DAMFOPI4.doc <br />�® REG /ST <br />4 '• <br />s <br />0 <br />io • <br />l <br />Z8 <br />