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<br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: 1`,•SS ,. !>k~ Date: ~~ -'L(-~.) <br />NPDES ID. No.:CO-0000213 007 Date Last Inspected: q•-Z-r _.Za~~ <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #007 Location:47N15W6 <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 APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) ® No <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan Ye No <br />9. Burning (specify extend and location) Yes No <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br />a.) From underdrain pipes: Yes <br /> b.~ At isolated points on embankment slopes: Yes Qo <br /> c) At natural hillside: Yes <br /> tl) Over widespread areas Yes 0° <br /> e) Fmm downsteam foundation area Yes <br /> f) "Boils" beneath stram or ponded water Yes <br />7. Cracks or scarps on crest Yes Q <br />B. Cracks or scraps on slope Yes ~~ <br />9. Sloughing or bulging on slope Yes QO <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 No <br />a <br />19. Existing embankment freeboard (feet) ~. <br />15. Cracks, bulging, or ezosion on upsteam face Yes ~o <br />16. Visible sumps or sinkholes in slurry surface Yes <br />17. Clogging <br />a) Spillway channels and pipes Yes <br />b) Decant system Yes <br />c) Di Ve rsion Ditches Yes <br />18. Cracking or crushing of pipes <br />a) Spillway pipes Yes <br />b) Decant System Yee s~ <br />19. Trash racks1 clear and in place `` Q <br />IS hcr~ 6`SGMCrr~~r~ q~ ~F, tr.~ ~'~ <br />P~~ ~ <br />,.~, ~~r5~ a`S~.orS.~~ ,~ao ~'.~~ <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 />N/A <br />N/A <br />® N/A <br />N/A <br />No N/A .`j <br />~4 f ~J Y~\~ <br />\Z- 21, 2c e.7 <br />