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PERIODIC INSPECTION FORM <br />dater, Sedi~ent, or Slurry lopoundments <br />INSPECTOR'S NAME: ~~~; S Jo'~• e 5 DATE: 3 ' Z Z- 6Y <br />N.P.D.E.S. I.D. NO.: rn_nnnm ~t n_P. nna <br />FACILITY CONFIGURATION: Crass-Va11Py Pond DATE LAST INSPECTION: / 2 -~`~- $ ~ <br />SITE NAME: ~ Cniith Sartinn ]7 Pnnr1 Hnn4 LOCATION: SW'aSE'a. Sec. 12. TSN. R87W <br />MINE NAME: ~ CanarR ti Minr (PPaho y Cnal Comoanvl LOCATION: 7.1 mi. SE of Havden. CO <br />MINE I.D. NO.: LMIRR Parmit Nn_ r.-nnh-An OWNER'S REP.: Don Tian. Cip~ <br />Circle or write in appropriate response <br />1. Foundation preparation (removal of vegetation, stumps, topso117) Ye No <br />2. Lift thickness (inches) ~_ inches <br />3. Compaction according to approved plan Yes No <br />4. Burning (specify extent and location) N~q YX <br />i 5. Angle of slope~degre~ F•1 iinctrPam, 9~1 rinwnstraam. total = ]~'~~" <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes Yes o <br /> At isolated points on embankment s opes Yes <br /> At natural hillside Yes <br /> Over widespread areas Yes o <br /> From downstream founds ton area Yes <br /> "Boils" beneath stream or ponde water Yes <br />7. Cracks or scarps on crest ULrIl~ Yes No <br />8. Cracks or scarps on slope V~I(~ Yes No <br />9. Sloughing or bulging on slope Yes ©o <br />10. *Ma,)or erosion problems Yes <br />11. Surface movements in valley bottom or on hillside Yes <br />12. *Erosion of toe es No <br />13. *Water impounded against toe ~ Yes <br />14. Existing embankment freeboard (feet) S~ feet <br />15. Increase Decrease in water level (feet) c.~ feet <br />16. Cracks, bulging, or erosion on upstream face Yes ~ <br />17. Visible sumps or sinkholes in slurry surface N/A (XXib <br />18. *Clogging <br /> Spillway channels and pipes Yes <br /> Decant system Yes QIa <br /> Diversion ditc es Yes <br />19. *Cracking or crushing of pipes <br /> Spillway pipes Yes <br /> Decant system Yes <br />Z0. Trash racks clear and in place ~ tV/A Xifl<XXNIi <br />*Ma~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 condi- <br />tions noted in these items should normally be described (extent, location, volume, etc.) <br />in the space on the back of this sheet. <br />