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<br /> <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: A o55 Gvt\o~ Date: o~ _ oq. 05 <br />NPDES ID. No.:CO-0000213 Date Last Inspected:03 - ~4-- OS <br />Facility Configuration: Cross Valley Pond <br />Site Name: Impoundment #007 Location:4 6N15W SEC 6 <br />Mine Name: New Horizon Mine Location:l mi.NW of Nucla . CO. <br />Mine ID No.: CDMG Permit #0008-81 <br />Owners Rep.: R. L. Wade. Mine Mana4er <br /> CIRCLE OR WRITE IN APPROPRIATE R ESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., tops oil) Ye No N/A <br />2. Lift thickness (inches) ~ 7. i~yc.~ <br />3. Compaction according to approved plan Ye No N/A <br />9. Burning (specify extend and location) Yee ~ <br />~'~ N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) From unde rdrain pipes: Yes ® N/A <br /> b.) At isolated points on embankment slopes: Yes ~ NJA <br /> c) At natural hillside: Yes Q° N/A <br /> d) Over widespread areas Yes N~ N/A <br /> e) From downst eam foundation area Yea ® N/A <br /> f) "Boils" beneath stram or ponded water Yes ® N/A <br />7. Cracks or scarps on crest Yes ® N/A <br />e. Cracks or scrape on slope Yes ~ N/A <br />9. Sloughing or bulging on slope Yes ® N/A <br />10. Maj of erosion problems Yes ~ N/A <br />11. Surface movements in valley bottom or on hillside Yes ~ N/A <br />12. Erosion of toe Yes S~ N/A <br />13. Water impounded against toe Yes ® N/A <br />14. Existing embankment freeboard (feet) ~y~ ~ Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes u~9 N/A <br />16. Visible sumps or sinkholes in slurry surface Yes ~ N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yes ® N/A <br /> b) Decant System Yee ~ N/A <br /> c) Diversion Ditches Yes Q~ N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes (E~ N/A <br /> b) Decant System Yes ~ N/A <br />19. Trash racks clear and in place ~ No N/A <br />F:\Eng\DATA\WP\pond-banks\DAMFORM.wpd <br />V w" - <br />