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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: ,/E~ L~~~^' <br />NPDES ID. No.: CD^0000213 005 <br />Facility Configuration: Cross Valley Pand <br />Site Name: Impoundment b 005 <br />Mine Name: New Horizon Mine Western Fuels-Co <br />Mine ID No.:CMLRD Permit b@008-SI <br />Dwners Rep.: R, L. Wade. Mine Manager <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />S. <br />9. <br />10. <br />11. <br />12. <br />13. <br />14. <br />15. <br />16. <br />17. <br />10. <br />19. <br />Date: 5 ~b ~9`~ <br />Date Last Inspected: ~-S-vY <br />Location: 4)N16W36AD <br />Location:2 mi. NN of Nucla, Co. <br />CIRCLE OR NRITE IN APPROPRIATE RE6PONSE <br />Foundation Preparation (removal of vegetation, stumps, topsoil) Ye No N/A <br />Lift thickness (inches): /Z ;~~G~S Yes No N/A <br />Compaction according to approved plan: ~ No N/A <br />Burning (specify extent and location): Yes ® N/A <br />Angle of slope: 3:1 upstream, 3:1 downstream, Total 6:1 <br />Seepage (specify location, color, and approx. volume) <br />From underdrain pipes: <br />At isolated points on embankment <br />At natural hillside: <br />Over widespread areas: <br />From downstream foundation area: <br />"Boils' beneath stream or ponded <br />Cracks or scarps on crest: <br />Cracks or scarps on slope: <br />Sloughing or bulging on slope: <br />+:Major erosion problems: <br />Surface movements in valley bottom or <br />+:Erosion of toe: <br />*Water impounded against toe: <br />Existing embankment freeboard (feet): <br />increase or decrease in water <br />Cracks, bulging, or erosion on upstream face:_ <br />Visible sumps or sinkholes in slurry surface:_ <br />*Clogging <br />Spillway channels and pipes: <br />Decant system: <br />Diversion ditches: <br />sCracking or crushing of <br />pipes <br />Spillway pipes: <br />Decant system: <br />20. Trash racks clear and in place: <br />*Major adverse changes to these items <br />to the Chief Engineer and Mine Manager <br />noted in these items should normaII <br />on page two of this inspection form <br />/ o n 6' w 4 S ~~/ <br />slopes• <br />water• <br />on hillside: <br />could cause <br />f gr,.,#~Lt h e r <br />level (feet): <br />Yes No /A <br />Yes C~ N/R <br />Yes ® N/A <br />Yes N/A <br />Yes ~ N/A <br />Yes ~ N/A <br />Yes o N/A <br />Yes N/A <br />Yes o N/A <br />Yes o N/A <br />Yes N/A <br />Yes o N/A <br />Yes r N/A <br />/3.z5 Feet <br /> O Feet <br />Yes N/A <br />Yes ~ N/A <br />Yes o N/A <br />Yes o N/A <br />Yes °~ N/A <br />Yes No , N/A <br />Yes o. ' N/R <br />es., No N/A <br />instability and should be reported <br />evaluation. Adverse conditions <br />d (extent, location, volume, etc.) <br />~ R_R~" <br />