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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: Zass G„dc. Date: ~_ IZ--Zoo( <br />NPDES ID. No.:CO-0000213 008 Date Last Inspected: ~-ZI-2oul <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #008 Location:47N15W6 <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 /> <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 />19 <br />Foundation Preparation (removal oC vegetation, stumps., topsoil) ~ No <br />Lift thickness (inches) <br />Compaction according [o approved plan Ye No <br />Burning (specify extend and location) Yes <br />Angle of slope: 3:1 upstream, 3:1 downstream <br />Seepage (specify location, color, and approx. volume) <br />a.l From underd rain pipes: Yes (A~ <br />b.) At isolated points on embankment slopes: Yes <br />C1 AC naCU ral hillside: Yes <br />d) Over wrdesp read areas Yes <br />e1 From downs[eam foundaCion area Yes <br />f) "Boils" beneath scram or ponded water Yes <br />CracY,S o[ scarps on crest Yes <br />Cracks oc scraps on slope Yes <br />Sloughing or bulging on slope Yes <br />Major erosion problems Yes Ind <br />Surface movements in valley bottom or on hillside Yes ©o <br />Erosion of toe Yes <br />Water impounded against toe Yes o~ <br /> <br />Existing embankment freeboard (feet) <br />Cracks, bulging, or erosion on upsteam face Yes No <br />Visible sumps or sinkholes in slurry surface Yes <br />Clogging <br />a) Spillway channels and pipes Yes <br />b) Decant system Yes <br />c) Diversion Ditches Yes <br />Cracking or crushing of pipes <br />al Spillway Yes (~ <br />bl Decant sy Yes SSG~iddd <br />T cash roc Y.S cleat Yes No <br /> <br /> <br />c:\data\vpda[a \damform.d <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/.4 <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 />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />,L.-~~ <br />