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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Rov Karo DATE: 09/25/95 <br />NPDES I.D. NO.: CO-0000221 D. P. 009 <br />FACILITY CONFIGURATION: Cross-Valley Pond DATE LAST INSPECTION: 06/28 /95 <br />SITE NAME: Pond #009 ,!LOCATION: SEY. SWY.. Sec. 11. TSN. R88W <br />MINE NAME: Seneca II-W Mine (Seneca Coal Col ~ LOCATION: 8 mi. S of Ha yden. CO <br />MINE I.D. NO.: CMLRD Permit No. C-82-057 OWNER'S REP.: Scott Wil liams . Gen Mar <br />Cirole or write in appropriate response <br />1 <br />2 <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 />Foundation preparation (removal of vegetation, stumps, topsoil: es No N/A <br />Lift thickness: 12 in. N/A <br /> <br />Compaction according to approved plan: es No N/A <br />Burning (specify extent and location): Yes No <br />Angle of slope: 3:1 upstream, 3:1 downstream To tal = 6:1 N/A <br />*Seepage (specify location, color, and approximate volume) <br />From underdrain pipes: Yes No /A <br />At isolated points on embankment slopes: Yes ~ N A <br />At natural hillside: Yes N/A <br />Over widespread areas: Yes N/A <br />From downstream foundation area: Yes N/A <br />"Boils" beneath stream or ponded water: Yes ~ <br />o N/A <br />Cracks or scarps on crest: Yes o N/A <br />Cracks or scarps on slope: Yes N/A <br />Sloughing or bulging on slope: Yes ~ <br />o N/A <br />*Maj or erosion problems: Yes o N/A <br />Surface movements in valley bottom or on hillside: Yes o N/A <br />*Erosion of toe: Yes o N/A <br />*Water impounded against toe: Yes o N/A <br />Existing embankment freeboard: Approximately 13 fe et <br />Increase X Decrease in water level: 3 fe et <br />Cracks, bulging, or erosion on upstream face: Yes No N A <br />Visible sumps or sinkholes in slurry surface: Yes No /A <br />*Clogginq <br />Spillway channels and pipes: Yes <br />Decant system: Yes <br />Diversion ditches: Yes <br />19. *Cracking or crushing of pipes <br />Spillway pipes: Yes <br />Decant system: Yes <br />20. Trash racks clear and in place: es <br />®° N <br />No <br />No /A <br />Q N A <br />No /A <br />No N/A <br />*Maj or adverse changes in these items could cause instability and should be reported to <br />the Engineering Manager and Mine Superintendent for further evaluation. Adverse <br />conditions noted in these items should normally be described (extent, location, volume, <br />etc.) in the space on the back of this sheet. <br />