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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name:~SS ~~~~,,, Date: li -~~^9q <br />NPDES ID. No.:CO-0000213 008 Date Last Inspected: 3_I$.gcl <br />Faci lity Configuration:Cross Valley Pond <br />Site Name: Impoundment #008 Location:9 7N15W6 <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla, CO. <br /> <br />Mine ID No.: CMLRD Permit #0008-61 <br />Owners Rep.: R. L. Wade. Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE R ESPONSE <br />1. Foundation Prepara [i on (removal of vegetation, stumps., topsoil) Yes No N/A <br />2. Lift thickness (inches) <br />3. Compaction accortling to approved plan Yes No N/A <br />4. Burning (specify extend and location) Yes No N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.l From underd ra in pipes: Yes o N/A <br /> b.) AC isolated points on embankment slopes: Yes N N/A <br /> cl At natural hillside: Yes Qo N/A <br /> d) Over widespread areas Yes N N/A <br /> e} From down5team foundation area YES J~ N/A <br /> EI "Boils" beneath stram Or pondetl water Yes ~ N/A <br />7. CracYS or scarps on crest Yes N N/A <br />B. Cracks or scraps on slope Yes ~ N/A <br />9. Sloughing or bulging on slope Yes ~ N/A <br />10. Maj Or erosion problems Yes ~ N/A <br />11. Surface movements in valley bottom or on hillside Yes No N/A <br />12. Erosion of toe Yes ~ N/A <br />13. Water impounded against toe Yes ~ N/A <br />14. Existing embankment freeboard (feet) ~ _ Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes ~ N/A <br />16. Visible sumps or sinkholes in slurry surface Yes Q' N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yes ~ N/A <br /> bl Decant system Yes ~/ N/A <br /> c) Diversion Ditches Yes ~~ N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes ®° N/A <br /> bl Decant system Yes ~ N/A <br />19. Trash Lacks clear dnd in place ~Sa No N/A <br /> <br />c:\data\wpdata\damform.doc <br /> <br />