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PERIODIC INSPECTION FORM <br />Water, Sediment, ar Slurry Impoundments <br />INSPECTOR'S NAME: ~p~.~ ; S ~o `~. e 5 DATE: 3 - Z Z- 6 <br />N.P.D.E.S. I.D. NO.: rn_nnnm ~i n n non <br />FACILITY CONFIGURATION: -Cross-Valley Pond DATE LAST INSPECTION: / 2 -/~~- $ 7 <br />SITE NAME: Smith Sartinn 17 Pnnd Nnn4 LOCATION: SW'~SE'a. Sec. 12. T5N. R81W <br />MINE NAME: ~ SpnPra Ti Mina ~•paahndy foal fomoanv) LOCATION: 7.1 mi. SE of Nayden CO <br />MINE I.D. NO.: f.MIRR Parmit Nn_ f.-005-AO OWNER'S REP.: Don Zulian. Supt. <br />Circle or write in appropriate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoil7) Ye No <br />2. Lift thickness (inches) ~_ inches <br />3. Compaction according to approved plan Yes No <br />4. Burning (specify extent and location) _ N/A YxEI~(XXrA9( <br />i 5. Angle Of slope-{deelre~ 5•i nnctrpam, 9~1 rinwnctraam. total = ];,j~" <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes Yes o <br /> At isolated points on embankment s opes Yes <br /> At natural hillside Yes <br /> Over widespread areas Yes o <br /> From downstream founds ion area Yes <br /> "Boils" beneath stream or ponde water Yes <br />7. Cracks or scarps on crest Ut~{p Yes No <br />8. Cracks or scarps on slope I/t`/ Q Yes No <br />9. Sloughing or bulging on slope ~ Yes ©o <br />10. *Major erosion problems _ Yes to <br />11. Surface movements in valley bottom or on hillside Yes <br />12. *Erosion of toe es No <br />13. *Water impounded against toe ~ Yes <br />14. Existing embankment freeboard (feet) S feet <br />15. Increase Decrease in water level (feet) Ca feet <br />16. Cracks, bulging, or erosion on upstream face Yes loo <br />17. Visible sumps or sinkholes in slurry surface N/A )6?tlS(XXVb <br />18. *Clogging <br /> Spillway channels and pipes Yes <br /> Decant system Yes <br /> Diversion ditc es Yes <br />19. *Cracking or crushing of pipes <br /> Spillway pipes Yes <br /> Decant system Yes <br />20. Trash racks clear and in place ~ Il/A XBtX XpB <br />*Ma~ or adverse changes in these items could cause instability and should be repo rted 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 t he space on the back of this sheet. <br />