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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Dennis Jones DATE: ~ ~~~ ~~ <br />NPDES I.D. NO.: CO-0000221 D.P. 004 <br />FACILITY CONFIGURATION: Cross-Valley Pond <br />SITE NAME: South Section 12 Pond #004 <br />MINE NAME: Seneca II Mine (Seneca Coal Co) <br />MINE Z.D. NO.: CMLRD Permit No. C-80-005 <br />1 <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />9 <br />10 <br />11 <br />12 <br />13 <br />14 <br />15 <br />16 <br />17 <br />18 <br />19 <br />20 <br />DATE LAST INSPECTION: V -I~ ~yO <br />LOCATION: SW'/. SE'/,, SeC. 12, TSN R87W <br />LOCATION: 7.1 mi. SE of Hayden CO <br />OWNER'S REP.: Grego Kitchen. Gen Mar <br />Circle or Write in aDDrooriate response <br />Foundation preparation (removal of vegetation, stumps, topsoil: Yes <br />Lift thickness: 12 <br />Compaction according to approved plan: Yes <br />Burning (specify extent and location): No <br />Angle of slope: 5:1 upstream, 2:1 downstream Total = 7:1 <br />*Seepage (specify location, color, and approximate volume) <br />From underdrain pipes: N A <br />At isolated points on embankment slopes: Yes N N/A <br />At natural hillside: Yes No N/A <br />Over widespread areas: Yes No N/A <br />From downstream foundation area: Yes No N/A <br />"Boils" beneath stream or ponded water: Yes No N/A <br />Cracks or scarps on crest: Yes No N/A <br />Cracks or scarps on slope: Yes No N/A <br />Sloughing or bulging on slope: Yes No N/A <br />*Major erosion problems: Yes No N/A <br />Surface movements in valley bottom or on hillside: Yes No N/A <br />*Erosion of toe: Yes No N/A <br />*Water impounded against toe: Yes N N/A <br />Existing embankment freeboard: (normal = 4.8') ~~ feet <br />Increase Decrease in water level: h o c ~e.~~ feet <br />Cracks, bulging, or erosion on upstream face: Yes No N/A <br />Visible sumps or sinkholes in slurry surface: <br />*Clogging <br />Spillway channels and pip <br />Decant system: <br />Diversion ditches: <br />*Cracking or crushing of pipes <br />Spillway pipes: <br />Decant system: <br />Trash racks clear and in place: <br />s: Yes No N/A <br />Yes No N/A <br />Yes No N/A <br /> <br />Yes No N/A <br />Yes o N/A <br />Yes No e <br />N/A <br />*Major adverse changes in these items could cause instability and should be reported to the <br />Engineering Manager and Mine Superintendent for further evaluation. Adverse conditions noted in <br />these items should normally be described (extent, location, volume, etc.) in the space on the <br />back of this sheet. <br />