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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: finis ~,>\r.~fo. Date: ,~, ~ Zl -~ Zvi <br />NPDES ID. No.:CO-0000213 001 Date Last Inspected: q..'L'~-~ <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #001 Location:47N16W36BC <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla. CO. <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owners Rep.: R. L. Wade. Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIAT E RESPONSE <br /> <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) Ye No <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan es No <br />4. Burning (specify extend and location) Yes <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> <br />a.) From underdrain pipes: <br />Yes r--~ <br />veyy <br /> b.) At isolated points on embankment slopes: Yes ~TO~ <br /> c) At natural hillside: Yes ~}, <br /> d) Over widespread areas Yes N(~n <br /> e) From downsteam foundation area Yes No <br /> f) "Boils" beneath stram or ponded water Yes <br />7. Cracks or scarps on crest Yes <br />8. Cracks or scraps on slope Yes Q <br />9. Sloughing or bulging on slope Yes Q <br />10. Major erosion problems Yes <br />11. Surface movements in valley bottom or on hillside Yes <br />12. Erosion of toe Yes <br />13. Water impounded against toe Yes ~ <br />14. Existing embankment freeboard (feet) ~ <br />15. Cracks, bulging, or erosion on upsteam face Yes <br />16. Visible sumps or sinkholes in slurry surface Yes t~ <br />17. Clogging <br />a) Spillway channels and pipes Yes <br />b) Decant System Yes <br />c) Diversion Ditches Yes <br />18. Cracking or crushing of pipes <br />a) Spillway pipes Yes <br />b) Decant system <br />19. Trash racks clear and in <br />c:\data\wpdata\damform.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 />/~ N/A <br />/1 N/A <br />N~ N/A <br />N/A <br />N/A <br />No N/A <br />J <br />