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PERIODIC INSPECTION FORM <br />Yater. Sediment. or Slurry Iepoundments <br />INSPECTOR'S NAME: ~/~.Q~,.,,.:s ~oU4 s <br />N.P.D.E.S. I.D. NO.: rn_nn0~71 n.P. nna <br />FACILITY CONFIGURATION: Cross-Valley Pond <br />SITE NAME: Snirth Sartinn 17 Pnnd ann4 <br />MINE NAME: ~ Svnaca ii Mine (Paahn y Cnal Comoanvl <br />MINE I.D. NO.: f.Ml RR Parmit Nn_ f.-nnri-Rn <br />DATE:. c!-? S-S~ <br />DATE LAST INSPECTION: 6 -~ -?56 <br />LOCATION: ~!aSEy, Sec. 12. T5N. R81W <br />LOCATION: 7 1 mi. SE of Flavden. CO <br />OWNER'S REP.: Don Zulian. Soot. <br />Circle ar ririte in appropriate response <br />1. Foundation preparation (removal of vegetation, stoops, topsoil7) Ye No <br />2. Lift thickness (inches) ~Z inches <br />3. Compaction according to approved plan Yes No <br />4. Burning (specify extent and location) N/A YXEI~(xX~9( <br />i 5. Angle of Slope ~degre~ 5.1 unctraam 7~1 downstream. total = ]~'de'!~~ <br />6. *Seepage (specify location, color, and approximate volume} <br /> From underdrain pipes ~ No <br /> At isolated points on embankment s opes Yes <br /> At natural hillside Yes Q4n7 <br /> Over widespread areas Yes ~Cd <br /> From downstream founds loo area es No <br /> "Boils" beneath stream or ponde water Yes ®o <br />7. Cracks or scarps on crest Yes No <br />8. Cracks or scarps on slope Yes No <br />9. Sloughing or bulging on slope Yes No <br />10. *Major erosion problems Yes No <br />11. Surface movements in valley bottom or on hillside Yes No <br />12. *Erosion of toe Yes No <br />13. *Water impounded against toe Yes No <br />14. Existing embankment freeboard (feet) _~ feet <br />15. Increase _~ Decrease in water level (feet) .rd cPis.l.~~Ge ~k~ue,.d c~,L feet <br />16. Cracks, bulging, or erosion on upstream face Yes Q <br />17. Visible sumps or sinkholes in slurry surface IJ/A W~6'(Xkib <br />18. *Clogging <br /> Spillway channels and pipes Yes o <br /> Decant system Yes <br /> Diversion ditc es Yes <br />19. *Cracking or crushing of pipes <br /> Spillway pipes Yes <br /> Decant system Yes o <br />20. Trash racks clear and in place N/A XXiIXXpii <br />*Ma,)or adverse changes in these items could cause instability and should be reported to <br />the Engineering Manager and Mine Superintendent for further evaluation. Adverse condi- <br />tions noted in these items should normally be described (extent, location, volume, etc.) <br />in the space on the back of this sheet. <br />