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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: ~~s5 Ci..t~ Date: g_ IZ. ZOcI, <br />NPDES ID. No.:CO-0000213 006 Date Last Inspected: 6-ZI-Zool <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #006 Location:97N16w36AC <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 <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 />l9 <br />1~ <br />Foundation Preparation (removal of vegetation, stumps., topsoil) ~ No <br />Lift thickness (inches) <br />Compaction according [o approved plan <br />Burning (specify extend and location) <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />Seepage (specify location, color, and approx. volume) <br />a.) From underd rain pipes: <br />b.l AC Jsola[ed poJnts on emba nkment slopes: <br />c) At natural hillside: <br />dl Over widespread areas <br />el From downs team foundation area <br />f) "Boils" beneath scram oc pontled eater <br />Cracks or Scarps on Crest <br />Cracks or scraps on slope <br />Sloughing or bulging on slope <br />Major erosion problems <br />Surface movements in valley bottom or on hillside <br />Erosion of toe <br />water impounded against toe <br />Existing embankment freeboard (feet) <br />Cracks, bulging, oc erosion on upsteam face <br />Visible sumps or sinkholes in slurry surface <br />Clogging <br />al Spillway channels and pipes <br />bl Decanc system <br />c) Diversion Ditches <br />Cracking or crushing of pipes <br />a) Spillway pipes <br />b) Decant s <br />Trash racks cl ea <br /> <br />c:\data\wpdata\tlamform.i <br />N/A <br /> No N/A <br />Yes ® N/A <br />Yes No N/A <br />Yes N~ N/A <br />Yes N~ N/A <br />Yes ® N/A <br />Yes ® tJ/A <br />Yes '~ N/A <br />YES ~ N/A <br />Yes ® N/A <br />Yes N~ N/A <br />Yes ® N/A <br />Yes ~ N/A <br />Yes ~ N/A <br />Yes ® N/A <br />ZI <br />I Feet <br />Yes f~ N/A <br />Yes /W~C~ N/A <br />Yes N® N/A <br />Yes ® <br />' N/A <br /> ~~ <br />\\ <br />Yes `Elp/ tl/A <br />Yes ~ N/A <br />Yes ~ N/A <br />Ye No N/A <br />~,~~_oi <br />