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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: 1~,ss G.,b~ Date: q-Z~•w <br />NPDES ID. No.:CO-0000213 007 Date Last Inspected: x.21_0,, <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.: R. L. Wade, Mine Manager <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) Y y. No N/A <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 />18 <br />19. <br />Lift thickness )inches) <br />Compac [i on according to approved plan ~. 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.) From underdrain pipes: Yes <br />6.1 AC isolated points on embankment slopes: Yes <br />cl At natural hillside: Yes <br />d) Over widespread areas Yes <br />e) From downsteam foundation area Yes <br />f) "Boils" beneath stram or ponded water Yes Cam, <br />Cracks or scarps on crest Yes <br />Cracks or scraps on slope Yes <br />Sloughing or bulging on slope Yes <br />Major erosion problems Yes f~e <br />Surface movements in valley bottom or on hillside Yes <br />Erosion of toe Yes <br />Water impounded against toe Yes Po~ <br /> r <br />Existing embankment freeboard (feet) _ ~ <br />Cracks, bulging, or erosion on upsteam face Yes <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 o[ pipes <br />a) Spillway pipes Yes <br />b) Decant Yes ~O <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 />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />Trash racks cle ~ No <br />c: \data\wpdata\tlamform <br />Q ^Z7,-.? <br />