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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: 1~os5 ~,~~ Date: ~ _z f_ 2m ~ <br />NPDE S ID. No.:CO-0000213 006 Date Last Inspect ed:,]-z9- 2.a/ <br />Faci lity Configuration:Cross Valley Pond <br />Site Name: Impoundment #006 Location:97N16W36 AC <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucl a, CO. <br /> <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owners Rep.: R. L. Wade. Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Founda [ion Preparation (removal of vegetation, stumps., [opsoitl ~ No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan -Ye No N/A <br />4. Burning (specify extend and location) Yes ~ N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify Location, color, and approx. volume) <br /> a.) From undertlracn pipes: Yes ® N/A <br /> b.) AC isolated points on embankment slopes: Yes td"T' N/A <br /> cl Ai natural hillside: Yes N N/A <br /> dl Ovec widespread a[eas _ Yes NO N/A <br /> el From downsteam fountlation area Yes (fib N/A <br /> fl "Boils" beneath scram or ponded water Yes ® N/A <br />7. Cracks or sCd rps On crest Yes V N/A <br />8. Cracks or scraps on slope Yes ~~r N/A <br />9. Sloughing or bulging on slope Yes (N~ N/A <br />30. Hajor erosion problems Yes (~ N/A <br />11. Surface movements in valley bottom or on hillside Yes l~ N/A <br />12. Erosion of toe Yes N~ N/A <br />13. Water impounded against toe Yes LtjD' N/A <br />14. Existing embankment freeboa rtl (feet) ~ _ Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes N/A <br />16. Visible sumps or sinkholes in slurry surface Yes ~ N/A <br />17. Clogging <br /> al Spillway channels and pipes Yes `2.b~ N/A <br /> b) Decant system Yes V <br />'t~ <br />o N/A <br /> e) DLVe[sion Ditches Yes / <br />'~ <br />Ly0 N/A <br />18. Cracking or crushing of pipes <br /> al Spillway p N~ N/A <br /> bl Decant sys ~ N/A <br />19. Trash racks clear No N/A <br />/~'~' ~f~.fa r~e <br />c:\data\wpda[a\damform.do~ <br />~~~ZoU <br />