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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: G,~,~ Date: \Z-~_qq <br />NPDES ID. No.:CO-0000213 007 Date Last Inspected :- ~'-~q <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #007 Location:47N15W6 <br />Mine Nanle: New Horizon Mine Location:2 mi.NW of Nuc1a. 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 vega to Cron, stumps., topsoil) ~ No N/A <br />2. <br />3. <br />4 <br />5. <br />6. <br />7. <br />6 <br />5. <br />10. <br />11. <br />12. <br />13. <br />15. <br />15. <br />16. <br />17, <br />18 <br />19 <br />Lift thr~Y.ness (inches) <br />Compactron according Co approved plan <br />Burning )specify extend and loca[ion) <br />Angla of slope: 3:1 upstream, 3:1 downst re am_ <br />Seepage (specify location, color, and appro:;. volume) <br />a.) From, urderdrain pipes: <br />b.) At isolated points on emban kment slopes: <br />c) At natural hillside: <br />d) Over widesp road areas <br />e) FLOm dOWnStedm fOUnddClen died <br />f) "Boils" beneath stram or pontl ed water <br />Cracks or scarps on crest <br />C racY.s or scraps on slope <br />Sloughing or bulging on slope <br />Major erosion problems <br />Surface movements in valley bottom or on hillside <br />Erosion of toe <br />Water impounded against toe <br />E::i st inq embankment fxeebcaid (feet; <br />C rdc YS, bulging, or erosion on ups team face <br />Visible sumps or sinkholes in slurry surface <br />Clogarng <br />a) Spillway channels and pipes <br />b) Decant SySCem <br />c) Dr version Ditches <br />Crd d:i ng or crushing of pipes <br />a) Spillway pipes_ <br />b) Der_a nt sys <br />Trash racks clear <br />c:\data\wpdaCa\damform.do <br />IJO N/A <br />Yes do N/A <br />Yes Q <br />YES ~1 <br />Yes r.•~.' <br />ties to <br />Y25 <br />Y25 <br />Yes <br />Yes L1>-o7 <br />Yes <br />Yes <br />Yes LJ" <br />ties t~ <br />Yes ( <br />Yes <br />Yes <br />::/A <br />IJ/A <br />N/A <br />N/A <br />N/P. <br />N/A <br />N/A <br />IJ/A <br />N/A <br />rl/A <br />N/A <br />N/A <br />N/A <br />Feet <br />rva <br />IJ/A <br />Yes ~ N/A <br />Yes (N~ N/A <br />Y'es 'ol N/A <br />Yes @ N/A <br />l' /A <br /> /A <br />~z-G.q~ <br />