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<br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name:~_~t ~ ~~ Date: 9_y_gq <br />NPDES ID. No.:CO-0000213 006 Date Last Inspected : (s_/1-q 9 <br />Facil ity Configuration:Cross Valley Pond <br />Site Name: Impoundment #006 Location:9 7N16W36AC <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla . CO. <br /> <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE R ESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., tops oil) ® No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan ~ No N/A <br />4. Burning (specify extend and location) Yes ~. N/A <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 ® N/A <br /> b.) At isolated points on embankment slopes: Yes ~ [J/A <br /> c) At natu[al hillside: Yes PI~ N/A <br /> d) Over wides plead areas Yes (FIDE N/A <br /> eI From downsteam foundation area Yes ~ N/A <br /> f) "Boils" beneath stram or ponded water Yes ® !]/A <br />7. Cracks or Scalps on crest Yes Qo N/A <br />B. Cracks or scraps on slope Yes ~ N/A <br />9. Sloughing or bulging on slope Yes ~ tJ/A <br />10. Major erosion problems 1'es ® N/A <br />11. Surface movements in valley bottom or on hillside Yes J~ N/A <br />12 Erosion of toe ~ Yes ® IJ/A <br />13. Water impounded against toe Yes ~ ~ H/A <br />19. Existing embankment freeboard (feet) ~ Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes ® N/A <br />16. Visible sumps or sinY.hol es in slurry surface Yes ® N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yes ® N/A <br /> b) Decant System Yes ~ N/A <br /> c) Diversion Ditches Yes ® N/A <br />18. Cracking or crushing of pipes <br /> aI Spillway pipes Yes ® N/A <br /> b) Decant system 't es ® [J/A <br />19. Trash racks clear and in N/A <br /> <br />c: \data\wpdata\damform.doc <br />9-9°f <br />