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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: 1~os~ ~,~4 Date: 3- 10 -ZAC+O <br />NPDES ID. No.:CO-0000213 007 Date Last Inspected:IZ-6-Igc~~ <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #007 Location:97N15W6 <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla, CO. <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manaoer <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) Ye~ No <br />2 <br />3 <br />4 <br />5 <br />6 <br />7. <br />8. <br />9. <br />10. <br />11. <br />12. <br />13. <br />19. <br />15. <br />16. <br />17. <br />18 <br />19 <br />Lift thickness (inches) <br />Compaction according to approved plan <br />Burning (specify extend and location) <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />Seepage specify location, color, and approx. volume) <br />a.) From untlerd ra in pipes: <br />b.) At isolated pornts on embankment slopes: <br />U A[ natural hillside: <br />dl Over witl espread areas <br />el From downs team fountlation area <br />f) "Boils" beneath s[ram or ponded water <br />Cracks or scarps on crest <br />Cracks 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 />Existing embankment freeboard (feet) <br />Cracks, bulging, or erosion on upsteam face <br />Visible sumps or sinkholes in slurry surface <br />Clogging <br />al Spillway channels and pipes <br />b) Decant system <br />c) Diversion Ditches <br />Cracking or crushing o[ pipes <br />a) Spillway pipes <br />b) Decant system <br />Trash racks clear and in <br />c:\data\wpdata\damform.doc <br />No <br />Yes ( N~ <br />Yes N(~, <br />Yes <br />Yes <br />Yes , <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />1'e5 <br />Yes ~y <br />Yes ~ <br />Yes <br />Yes <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />Feet <br />N/A <br />N/A <br />Yes ~ N/A <br />Yes ~ N/A <br />Yes ® N/A <br />Yes No N/A <br />Yes [~ N/A <br />~~ o N/A <br />3- 1 O- "ico~7 <br />