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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: , ,~ Date: ~Z.. (~ _qq <br />NPDES ID. No.:CO-0000213 008 Date Last Inspected: Q-4 ~9 q <br />Far_ility Configuration:Cross Valley Pond <br />Site Name: Impoundment #008 Location:47D?15W5 <br />Mine Cda„e: New Horizon Mine Locaticn:2 mi.N'A ci Nucla. CO. <br />Mine I D Pdo.: CMLRC Permit #CCOS-8i <br /> <br />Owners Rep.: R. L. Wade, Mine i~ianager <br /> CIRCLE OR WRITE IN APPROPRIATE kESPUN~SE <br />i. Foundation Preparation Iremavai of vegetation, stumps., tops of i) ~ No N/A <br />... Lift thickness (inches) <br /> ~ <br />_. COIppaCClOn dCCOZdlnq t0 dppCO Ved pl dll NO N/A <br />4. Burning (specify e;at end and location) 'tes No N/A <br />5. A.nq le of slop?: 3:1 upst team, 3:1 downsf ream <br />6. Seepage (spec fy loco iron, color, and approx. volume) <br />7. <br />8. <br />9. <br />10 <br />ll <br />12 <br />13 <br />14 <br />15 <br />16 <br />17 <br />18 <br />19 <br />~u .~ O <br />a.l From underdrain pipes: 1'es <br />b.) Ai isolated pc.ncs cn embankment. slcpes: Yes <br />c) A[ natural hillside: Yes vycy <br />d) Over widespread areas 'fes ]® <br />e) From downsteam foundation area Y'es <br />fl "Boils" benea[h scram or ponded wa ter__ Yes <br />Cracks or scarps on crest Yes <br />Cracla or scraps on slope Yes to <br />Slough irq or bulging or. slope Yes Ja <br />Major erosion problems __ Yes <br />Surface movements in valley bottom or on hillside Yies C~ <br />cLGS1Dn of toe 'Les <br />Water impounded agains[ toe Yes 1 <br /> <br />Er.isting embankment freeboard (feet) _ __ ~ _ <br />CracY.S, bulging, or erosion on ups team face- Yes Noi <br />Visible sumps or sinY.hol es in slurry surfacery surface Yes J <br />Cloygrng <br />a) Spillway channels and pipes ~~./~ Yes <br />b) Decant =_ys tem. Iy ~A Y@s <br />c) Diversion Ditches ~1 A Yes <br />Cra ck.i ng or crushing of pipes <br />a) Spillway pipes Yes <br />b) Decant system Y@s <br />T rd sh cac Y.s clear and in place ]'@s <br />~S ~n~ tl~SGC..r~~r-` <br />^1- WQ~ 1 ll W Tu`A.t <br />c: \data\wptlata\damform.doc <br />N/A <br />ti/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />IJ/A <br />N/A. <br />N/A <br />N/A <br />N/A <br />N/A <br />Feet <br />IJ/A <br />N/A <br />No N/A <br />No N/A. <br />IJO N/A <br />iJO ./~ <br />No t~ <br />No /NTl9 <br />___J <br />f L -- 6 ~ °~ °'~ <br />