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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br /> <br />06/10/13 <br />INSPECTOR'S NAME: Chris Miller DATE: <br />NPDES I.D. NO.: CO-0048275 D.P. 004 <br />03/05/13 <br />FACILITY CONFIGURATION: Cross Valley Pond DATE LAST INSPECTION: <br />SITE NAME: South Section 12 Pond #004 LOCATION: SW¼ SE¼, Sec. 12, T5N, R87W <br />MINE NAME: Peabody Sage Creek Mine LOCATION: 7.1 mi. SE of Hayden, CO <br />MINE I.D. NO.: CMLRD Permit No. C-2009-087 OWNER'S REP.: Ed Brady <br /> <br /> <br />Circle or write in appropriate response <br /> <br /> <br /> <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: Yes <br /> <br />2. Lift thickness: 12 inches <br />3. Compaction according to approved plan: Yes <br />4. Burning (specify extent and location): No <br />5. Angle of slope: 5:1 upstream, 2:1 downstream Total = 7:1 <br />6. *Seepage (specify location, color, and approximate volume) <br />N/A <br />From underdrain pipes: _____________________________________ Yes No <br />No <br />At isolated points on embankment slopes:___________________ Yes N/A <br />No <br />At natural hillside: _______________________________________ Yes N/A <br />No <br />Over widespread areas: _____________________________________ Yes N/A <br />No <br />From downstream foundation area: ___________________________ Yes N/A <br />No <br />"Boils" beneath stream or ponded water: ____________________ Yes N/A <br />No <br />7. Cracks or scarps on crest: _______________________________________ Yes N/A <br />No <br />8. Cracks or scarps on slope: _______________________________________ Yes N/A <br />No <br />9. Sloughing or bulging on slope: ___________________________________ Yes N/A <br />No <br />10. *Major erosion problems: _________________________________________ Yes N/A <br />No <br />11. Surface movements in valley bottom or on hillside: ______________ Yes N/A <br />No <br />12. *Erosion of toe: _________________________________________________ Yes N/A <br />Yes <br />No <br />13. *Water impounded against toe: ____________________________________ N/A <br />14. Existing embankment freeboard: Normal = 4.8 ft _______________ 4.8 feet <br />15. Increase Decrease in water level: ___________________ feet <br />No <br />16. Cracks, bulging, or erosion on upstream face: ___________________ Yes N/A <br />N/A <br />17. Visible sumps or sinkholes in slurry surface: Yes No <br />18. *Clogging <br />No <br />Yes N/ <br />Spillway channels and pipes: _______________________________ A <br />N/A <br />Decant system: Inoperable _____________________ Yes No <br />No <br />Yes N/ <br />Diversion ditches: _________________________________________ A <br />19. *Cracking or crushing of pipes <br />No <br />Yes N/ <br />Spillway pipes: (See Below) _____________________ A <br />N/A <br />Decant system: : Inoperable ______________________ Yes No <br />Yes <br />N/A <br />20. Trash racks clear and in place: __________________________________ No <br />21. Discharge rate (gpm) _____________________________________________ 23 <br /> <br />*Major adverse changes in these items could cause instability an <br />Engineering Manager and Mine Superintendent for further evaluati <br />noted in these items should normally be described (extent, location, volume, etc.) in the <br />space on the back of this sheet. <br />