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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: Zo6s G 1ok.~ Date: (~ - 21- o~, <br />NPDES ID. No.:CO-0000213 001 Date Last Inspected: $-Ip-o 0 <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #001 Location:97N16W36BC <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla. CO. <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) ® No <br />2. Lift thicY.n esS (inches) ~ /,A <br />3. Compaction according to approved plan ~ No <br />4. Burning (specify e:a end and location) Yes ®° <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br />a.) From underd rain pipes: Yes <br />b.) At isolated points on emba n4:ment slopes: Yes NNQ <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 />c) At natural hillside: 'i es <br />dI Over widespread areas Yes No <br />e) From downsteam foundation area Yes No <br />f) "Boils" beneath scram or ponded water Yes ®° <br />C racY.s or scarps on crest Yes No <br />Cracks or scraps on slope Yes <br />Sloughing or bulging on slope Yes 0 <br />° <br />[1aj Or erosion problems Yes T <br />~J <br />Surface movements in valley bottom or on hillside Yes N <br />o <br />Erosion of toe Yes ^^ <br />v~5tn <br />Water impounded against toe Yes <br /> <br />Existing embankment freeboard (feet) I <br />~~ <br />Cracks, bulging, or erosion on upsteam face 'ies <br />Visible sumps or sinkholes in slurry surface Yes L~la <br />Cloggrng <br />a) Spillway channels and prpes Yes <br />b) Decant system Yes <br />c) Diversion Ditches Yes <br />Cracking or crushing of pipes <br />aI Spillway pipes Yes <br />h) Decant System Yes <br />Trash racks clear any <br />c: \data\wpdata\damform.doc <br />N/A <br />N/A <br />N/A <br />N/A <br />IJ /? <br />IJ/A <br />IJ/A <br />N/A <br />IJ/A <br />N/A <br />N/A <br />N/A <br />N/A <br />IJ/A <br />N/A <br />N/A. <br />Feet <br />IJ/A <br />N/A <br />N/A <br />® N/A <br />(~ N/A <br />N® N/A <br />No N/A <br />No N/A <br />~ z,_a° <br />