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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: ~„~s G,,b~ Date: 9-12-tool <br />NPDES ID. No.:CO-0000213 007 Date Last Inspected: ~-21.~~ <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #007 Location:97N15W6 <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla, CO. <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owners Rep.: ~. L. Wade, Mine Manager <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) ~ No N/p <br />2 <br />3 <br />9 <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 />IB <br />19 <br />Po~o~ is <br />Lift thickness (inches) <br />Compaction according to approved plan <br />Burning (specify extend and location) <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />Seepage (speci[y location, color, and approx. volume) <br />a.) Flom underd rain pipes: <br />b.) A[ isolated poin [s on embankment slopes: <br />c) A[ natural hiLlsid e: <br />d) Over witlespread areas <br />el From downsteam Coundation area <br />f) "Boils" beneath s[ram or ponded water <br />Cracks oc 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 hrllside <br />Erosion of toe <br />Water impounded against toe <br />Existing embankment freeboard (feet) <br />Cracks, bulging, or erosion on upsteam face <br />Visible sumps or sinkholes in slurry surface <br />Clogging <br />a) Spillway channels and pipes <br />b) Decant system <br />c) Diversion Ditches <br />Cracking or crushing oC pipes <br />a) Spillway pipes <br />b) Decant s <br />Trash racks cl ea <br />Lls [/"~ C r 1. 1 Y~ ~ <br />c:\da[a\wpdata\damfotm.~ <br />~e3'1 No <br />Yes ~, <br />Yes <br />Yes <br />Yes <br />Yes Q <br />Yes No <br />Yes ®o <br />Yes <br />Yes <br />Yes <br />Yes ®o <br />Yes <br />Yes ~d, <br />Yes ) 7a <br />Yes <br />Yes QTg1 <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />Feet <br />N/A <br />N/A <br />Yes ~ N/A <br />Yes ® N/A <br />Yes ~ N/A <br />Yes 0 N/A <br />Yes ~ N/A <br />Ye No N/A <br />