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<br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: ~~oSS G„~g Date: 3-zq-'2~o1 <br />NPDE S ID. No.:CO-0000213 001 Date Last Inspecte d:~Z_~_~~ <br />Faci lity Configuration:Cross Valley Pond <br />Site Name: Impoundment #001 Locat ion:97N16W36BC <br />Mine Name: New Horizon Mine Locat ion:2 mi.NW o f Nucla. 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. Foundation Preparation (removal of vegetation, stumps ., topsoil) Yes No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan Ye No N/A <br />9. Burning (specify extend and location) Yes ~ N/A <br />S. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.l From undecdcain pipes: Yes QI~ N/A <br /> b.l At isolated points on embankment slopes: Yes ~ N/A <br /> CI AC naCUral hillside: Yes ~ N/A <br /> d) Over widespread areas Yes r~ N/A <br /> el Eiom dOwnSCedm founda[t on area Yes ~ N/A <br /> fl "Boils" beneath stram or ponded water Yes moo, N/A <br />7. CCac ks or scarps on crest Yes ~ N/A <br />8. Cracks oc sccaps on slope Yes Q N/A <br />9. Sloughing or bulging on slope Yes ~g N/A <br />10. Major erosion problems ~ Yes ® N/A <br />11. Surface movements in valley bottom or on hillside Yes t~7o) N/A <br />12. Erosion of toe Yes ~ N/A <br />13. Hater impounded against toe Yes ~ ( ~. N/A <br />11. Existing embankment freeboard (feet) ~L Fee[ <br />15. Ctac ks, bulging, or erosion on upsteam face Yes ~ N/A <br />16. Visible sumps or sinkholes in slurry surface Yes No N/A <br />17. Clogging <br /> al Spillway channels and pipes Yes ~ N/A <br /> b) Decant system Yes o N/A <br /> c) Diversion DiCChes Yes N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes ~ry~ N/A <br /> bl Decant ~ N/A <br />19. Y[ash racks c1E No N/A <br />c:\data\wpda[a\damform <br /> <br />