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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name:~~ ~,lok~ Date: 3 -zg_2'c~ol <br />NPDE S ID. No.:CO-0000213 006 Date Last Inspecte d:~Z_7J _z~~ <br />Faci lity Configuration:Cross Valley Pond <br />Site Name: Impoundment #006 Locat ion:97N16W36A C <br />Mine Name:~lew Norizon Mine Locat ion:2 mi.NW o f 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. Foundation Preparation (removal of vegetation, stumps ., topsoil) Ye No N/A <br />2. Lift thickness (inches) <br />7. Compaction according to approved plan ~ No N/A <br />4. Burning (specify extend and location) Yes No N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.l From underd [ain pipes: Yes No N/A <br /> b.) AC isolated points on emban Y.ment slopes: Yes ~ N/A <br /> cl At natural hillside: Yes No N/A <br /> dl Over widespread areas Yes No N/A <br /> el Flom douns[eam fOUndation area Yes Rio N/A <br /> f) "Boils" beneath st[am o[ pontled water Yes No N/A <br />7. Cracks or scarps on crest Yes ~ N/A <br />8. C[ac k5 or Scraps on Slope Yes ~ N/A <br />9. Sloughing oI bulging On Slope Yes No N/A <br />10. Major erosion problems Yes ~o N/A <br />11. Surface movements in valley bottom or on hillside Yes do N/A <br />12. Erosion of toe Yes ~ N/A <br />1J. Water impounded against toe Yes ~ N/A <br /> <br />14. Existing embankment freeboard Ifeetl J ~ Fee[ <br />15. Cracks, bulging, or erosion on upsteam face Yes ~ N/A <br />16. visible sumps or sinkholes in slurry surface Yes ~1 <br />/'1 <br />~ca~ N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yes ® N/A <br /> bl Decant system Yes ~ N/A <br /> c) Diversion Ditches Yes (~y N/A <br />18. Cracking or crushing of pipes <br /> aI Spillway pipes 'Yes ~ N/A <br /> b) Decant s e <br />s @ N/A <br />19. Trash racks clea ' <br />3 No N/A <br />~ID ~ l$G\n4 Y~r Q <br />c:\data\~apdata\dam[orm.~ <br />3 -z9-~~ <br />