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PERIODIC INSPECTION FORM <br />FTATER, SIDIMENT, OR SLURRY <br />Inspectors Name : ~, t ~~ Date : q _ ~ g . q-~ <br />NPDES ID. No.:CO-0000213 006 Date Last Inspected: Z_2,3.Q1 <br />Facility Configuration:Cross Valley Pond <br />Site Name: Im~loundment #006 Location:47N16W36AC <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla CO. <br />Mine ID No.: CMLRD P <br />Owners Rep.: R. L. W <br /> CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, sturtq~s., topsoil) ~ No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan ~~ N <br />o N/A <br />9. Burning (specify extend and location) Yes ^ <br />* <br />~ N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) Frcm underdrain pipes: Yes N N/A <br /> b.) At isolated points on embanlmient slopes: Yes N/A <br /> c) At natural hillside: Yes `iG6~ N/A <br /> d) Over widespread areas Yes ~ N/A <br /> e) From downstream foundation area Yes ~ N/A <br /> f) "Boils" beneath scream or ponded water Yes ® N/A <br />7. Cracks or scarps on crest Yes ® N/A <br />B. 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 in valley bottom or on hillside Yes ~ N/A <br />12. Erosion of tce Yes N/A <br />13. Water impounded against tce Yes ~ <br />o N/A <br /> <br />19. <br />Existing embankment freeboard (feet) , <br />] <br />Feet <br />15. Cracks, bulging, or erosion on upstream face Yes ® N/A <br />16. Visible surt~s or sinkholes 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 /> a) Spillway pipes Yes ~ N/A <br /> b) Decant system Yes 1~11 <br />1 <br />Olo~ N/A <br />19. Trash racks clear and in place ® No N/A <br />~5 hp~ ~.S VNG.Y V\n~ <br />9. ~f 9? <br />