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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: ~a~ ~,~bKa Date: ~-Z~_q~ <br />NPDES ID. No.:CO-0000213 008 Date Last Inspected: '3.~D-tro <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #OUB Location:97N15W6 <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla. CO. <br />Mine ID No.: CMLRD Fermit #0008-81 <br />Owners Rep.: R. L. Wade. Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIAT E RESPONSE <br />1. Foundation Preparation (removal of vegetatron, stumps., tops pill ~ No <br />2. Lift thieY.ness (inches) <br />3. Compaction according [o approved plan Ye No <br />9. Burning (specify extend and location) 'fes No <br />5. Angle of slop _: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) From Underdrai^ pipes: Yes N <br /> b.I At isolated points on embankment slopes: 't es <br /> U AC natural hillside: Yes <br /> dl Over widespread areas Yes Q <br /> e) From Uownsteam foundation area Yes <br /> f) "Boils" beneath stram or pond ed water Yes Jo <br />7. Cracks or scarps on cc est Yes Q, <br />8. Cracks or scraps on slope Yes <br />9. Sloughing or bulging on slope Yes 0° <br />10. Major erosion problems 1'es <br />11. Surface movements in valley bottom or on hillside Yes <br />12. Erosion of toe Yes <br />13. Water impounded against Coe Yes Jo <br /> ~ <br />1S. Exist: rg embankment freeboard (.`eet) _ ~ <br />15. Cracks, bulging, or erosion on upsteam face Yes <br />16. Visible sumps or sr nL:hol es in ;lorry surface Yes <br />17. Clogging <br />a) Spillway channels and pipes Yes <br />b) Decanr system Yes <br />c) Diversion Ditches 'i es <br />18. Crac Y.ing or crushing of pipes <br />aI Spillway pipes 'fes <br />b) Der_ant system Yes <br />19. Trash racks clear and rn 'ies <br />Cora ,5 ~r~ <br />.: \data\wpda[a\damform.doc <br />CI/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />r;/A <br />N/A <br />N/A <br />N/A <br />N/A <br />r1/A <br />hl/A <br />IJ/A <br />N/A <br />N/A <br />Feet <br />N/A <br />N/A <br />t~ R/A <br />® N/A <br />NO N/A <br />No <br />IJO <br />Wo N! <br />L-z~-~ <br />