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<br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name:~ace ~_blc~ Date: <br />NPDES ID. No.:CO-0000213 008 Date Last Inspected: (o^1~-qo~ <br />Facility Configuration:Cross Valley Pond <br />Site Name: I~oundment #008 Location:9 7N15W6 <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 /> CIFCLE OR WRITE IN APPROPRIATE R ESPONSE <br />1. Foundatron Preparation (removal of vegeta [ion, stumps., tops oil) ~ No N/A <br />2. Lift thickness (ruches) <br />3. Compaction according to approved plan ® No [J/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 unde rd yarn prpes: Yes 1@ N/A <br /> b.) At isolated pornts on emban Y.ment slopes: Yes ® N/A <br /> c1 At natural hillside: Yes Q f11A <br /> d) Over widespread areas Yes ~ N/A <br /> e) From downsteam foundation area Yes ® N/A <br /> f) "Boils" beneath stram or ponded water Yes 1(~7 tLA <br />7. Cracks or scarps on crest Yes ~ N/A <br />8. Cracks or scraps on slope Yes ® N/A <br />9. Sloughing or bulging on slope Yes ® N/A <br />10. Major erosion problems Yes ~ N/A <br />11. Surface movements rn wall e}• bottom or on hillside Yes ~ N/A <br />12. Erosion of toe Yes ~ N/A <br />13. Water impounded against toe Yes ® N/A <br />14. Existing embankment freeboard (feet) _~ ~ Feet <br />15. Cracks, bulging, or erosion on ups ream face Yes ® N/A <br />16. Vrsrble sumps or sinkholes in slurry surface Yes ~ N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yes N N/A <br /> bI Decant system Yes Q° N/A <br /> cl Diversion Ditches Yes ~ N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes No N/ <br /> b) Decant system Yes IJO <br />19. Trash iac ks clear and in place Yes No <br />'JO~a }S ho~1 ~9e~se'~w~. <br />c:\data\wpdata\damform.doc <br />9 9 9~ <br />