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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Mine ID No.: CDMG Permit #0008 -81 <br />Owners Rep.: Rick Woiney, Mine Manager <br />- <br />2 <br />1. <br />Inspectors <br />Name : „,Zvc, )�2G f0- <br />Date: <br />2. <br />NPDES ID. <br />No.: CO- 0000213 <br />Date Last Inspected: <br />Facility Configuration: <br />Total Incised Pond <br />Yes <br />Site Name: <br />Impoundment #0015 <br />Location:47N 16W <br />SEC 36 <br />Mine Name: <br />New Horizon Mine <br />Location:l mi.NW <br />of Nucla, CO. <br />Mine ID No.: CDMG Permit #0008 -81 <br />Owners Rep.: Rick Woiney, Mine Manager <br />17. Clogging <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />a) Spillway channels and pipes <br />1. <br />Foundation Preparation (removal of vegetation, stumps., <br />topsoil) Y sD <br />No <br />2. <br />Lift thickness (inches) <br />a) Spillway pipes <br />3. <br />Compaction according to approved plan <br />Yes <br />No <br />4. <br />Burning (specify e::tend 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 appro::. volume) <br />a.) From underdrain pipes: <br />Yes <br />N <br />b.) At isolated points on embankment slopes: <br />Yes <br />i <br />c) At natural hillside: <br />Yes <br />d) Over widespread areas <br />Yes <br />e) From downsteam foundation area <br />Yes <br />f) "Boils” beneath stream or ponded water <br />Yes <br />LN <br />7. <br />Cracks or scarps on crest <br />Yes <br />D <br />8. <br />Cracks or scraps on slope <br />Yes <br />II <br />9. <br />Sloughinq_ or bulging on slope <br />Yes <br />No <br />10. <br />Ila-)or erosion problems <br />Yes <br />11. <br />Surface movements in valley bottom or on hillside <br />Yes <br />-1 <br />11. <br />Erosion of toe <br />Yes <br />0 <br />13. <br />Water impounded against toe <br />Yes <br />TI <br />14. <br />E::rscing embankment freeboard (feet) i t 15 Iii "-' l 6 <br />G, Z _ <br />8 <br />is. <br />Cracks, bulging, or erosion on upsteam face <br />Yes <br />16. <br />Visible sumps or sinkholes in slurry surface <br />Yes <br />LAY <br />17. Clogging <br />a) Spillway channels and pipes <br />Yes <br />b) Decant system <br />Yes <br />c) Diversion Ditches <br />Yes <br />18. Cracking or crushing of pipes <br />a) Spillway pipes <br />Yes <br />b) Decant system <br />Yes <br />19. Trash racks clear and in place <br />Yes <br />t <br />G:\ DATA \WP \pond- banl:s \DADIFOPM.doc <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 />No N /&- <br />No N/ <br />No N/A <br />No II /A <br />No / <br />No id /A <br />jsa;, <br />0 <br />• <br />zi!�Iso�l ,we., <br />.ZZ <br />