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' PERIODIC INSPECTION FORM <br />•. Mater, Sedirent, or Slurry Irapoundments <br />INSPECTOR'S NAME: pek.~.;s ~6~-~s <br />N.P.D.E.S. I.D. NO.: rn-nnnn~~T n_P nn3 <br />FACILITY CONFIGURATION: Cross-Valley Pond <br />SITE NAME: Pnnrl unna <br />MINE NAME: ~ SpnPfa TT Mine ~PPahn y foal fomoanvl <br />MINE I.D. NO.: f.MIRR Permit Nn. f-nnri-Rn <br />DATE: 3- Z Z -g6 <br />DATE LAST INSPECTION: /Z -I`I-S7 <br />LOCATION: Sy(,s;NWy. Sec. 7. T5N. R86W <br />LOCATION: yl mi. SE of Havden. CO <br />OWNER'S REP.: Don Z~ilian. Supt. <br />Circle or write in appropriate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoil7) Ye No <br />2. Lift thickness (inches) ~- inches <br />3. Compaction according to approved plan Yes No <br />4. Burning (specify extent and location) . NiA YXA~(XX~;9( <br />5. Angle of s10pe ~degre~ 3.1 unctrcam 3 ~1 downstream. total = ¢~'~~' <br />6. *Seepage (specify location, color, and approximate volume) <br />From underdrain pipes N A XRAXXb1R <br />At isolated points on embankment s opes Yes <br />At natural hillside Yes <br />Over widespread areas Yes o <br />From downstream founds ion area Yes o <br />"Boils" beneath stream or ponde water Yes o <br />7. Cracks or scarps on chest Yes ©o <br />8. Cracks or scarps on slope Yes ©o <br />9. Sloughing or bulging on slope Yes Qo <br />10. *Ma,jor erosion problems Yes I~ <br />11. Surface movements in valley bottom or on hillside Yes Qo <br />12. *Erosion of toe Yes <br />13. *Water impounded against toe ~ Yes No' <br />14. Exis ing embankment freeboard (feet) Avivr c;,T~ ;~(waN ,+~ cvP~~F ~•` feet <br />15. ~ Increase Decrease in water level (feet) - '~ '_o ' ? feet <br />i6. Cracks, bulging, or erosion on upstream face Yes <br />17. Visible sunps or sinkholes in slurry surface N/A 767g5(Xkib <br />18. *Clogging <br />Spillway channels <br />Decant system <br />Diversion ditcr~es <br />and pipes <br />No <br />1J'~(Xlt'dA( <br />~5(X)fip( <br />19. *Cracking or crushing of pipes <br />Spillway pipes Yes No <br />Decant system X)fkX <br />20. Trash racks clear and in place ~ Yes 'No <br />*Ma,jor 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 norm ally be described (extent, location, volume, etc.) <br />in the space on the back of this sheet. <br />