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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: IZcys G,~~q Date: Zp AuGvSi o7 , <br />NPDES ID. No.:CO-0000213 Date Last Inspected:Q6-S'.,.,~,Q7 <br />Facility Conf;guration: Cross Vallev Pond - <br />Site Name: Impoundment #007 Location:46N15W SEC 6 <br />Mine Name: New Horizon Mine Location:l mi NW of Nucla, CO. <br />Mine ID No.: CDMG Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1.' FCVndation Preparation (removal of vegetation, stumps., topsoil) ® No N/A <br />2.. Lift tbicimess (inches) <br />3. Compaction according to approved plan Ye No NJA <br />0. Burning (specify extend abd location) Yes ~ <br />~:1~ N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, wlor, a~ approx. volus~e) <br /> a.) From vaderdraia pipes: Yes ® NIA <br /> b.) At isolated points on embanloaent slopes: ~ YeS ~ N/A <br /> c) At natural hillside: Yes ~ N/A <br /> d) Over widespread areas Yes ® N/A <br /> e) Prom downsteam foundation area yes ~ N/A <br /> f) •BOils• beneath strain or ponded water yes ~ N/A <br />7. Cracks or scarps on crest Yes ~ N/A <br />6. Cracks or scraps on 61ope Yes ®' N/A <br />9. Sloughing or bulging oa slope Yes ~ N/A <br />10. Major erosion problems Yes ~ N/A <br />il. Surface voyemeats in. valley bottom or on hillside Yea ~ N/A <br />12. Erosion of tce Yes ~ N/A <br />13. Nater impounded against tce Yes <br />, l~ <br />~ N/A <br />1a. Existing emban3anent freeboard (feet) --bb <br />PP-- ---- Feet <br />15. Cracks, bulging, or erosion On upsteam face Yes ~ N/A <br />16. Visible sumps or sinkholes is slurry surface Yes ~ NJA <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 />16. Cracking or crushing of pipes <br /> a) Spillway pipes Yes ® N/A <br /> b) pecant system YeS N/A <br />19. Trash racks clear and in place N/A <br /> <br /> <br />o~ <br />p~,:~ <br />F:\Eag\DATA\F7P\pond-banks\DAMFORM.wpd <br />