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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: Jery` L.+gs0~/ <br />NPDES ID. No.: CO-0000215 001 <br />Facility Configuratimn: Cross Valley Pond <br />Site Name: Impoundment t 001 <br />Mine Name: New Horizon Mine Western Fuels-Ca <br />Mine ID Nm.:CMLRD Permit !0000-BI <br />Owners Rep.: R, L. Wade, Mine Manager <br />Date: 5~9~9'~ <br />Date Last Inspected: /'S-9Y <br />Location: 47N16W36BC <br />Location:2 mi. NW o4 Nucla, Co. <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps, topsoil) ~ No N/A <br />2. Lift thickness (inches): /Z :.,.l..s Yes No N/A <br />3. Compaction according to approved plan: ~s~ No N/A <br />4. Burning (specify extent and location): Yes ® N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream, Total = 6:1 <br />6. Seepage (specify location, color, and approx. volume) <br /> <br /> <br /> <br /> <br /> From underdrain pipes: Yes No G~LA <br /> At isolated points on embankment slopes: Yes '~~ N/A <br /> At natural hillside: Yes ® N/A <br /> Over widespread areas: Yes o N/A <br /> From downstream foundation area: Yes o N/A <br /> 'Boils" beneath stream or ponded water: Yes N/A <br />7. Cracks or scarps on crest: Yes o N/A <br />e. Cracks or scarps on slope: Yes o N/A <br />9. Sloughing or bulging on slope: Yes o N/A <br />10. +Major erosion problems: Yes o N/A <br />ll. Surface movements in valley bottom or on hillside: Yes N/A <br />12. +Erosion of toe: Yes t~q~1 N/A <br />13. +Water impounded against tae: Yes ~ N/A <br />14. Existing embankment freeboard (feet!: /5 Feet <br />I5. increase or decrease in water level (feet>: _ - O- Feet <br />16. Cracks, bulging, or erosion on upstre am face: Yes N N/A <br />17. Visible sumps or sinkholes in slurry surface: Yes N/A <br />16. +Clmgging <br /> Spillway channels and pipes: Yes ~ N/R <br /> Decant system: Yes ® N/A <br /> Diversion ditches: Yes ~ N/A <br />19. +Cracking or crushing of pipes <br /> Spillway pipes: Yes ~ N/A <br /> Decant system: Yes o N/A <br />20. Trash racks clear and in place: ~ Nm N/A <br />+Major adverse changes to these items could cause instability and should be reported <br />tm the Chief Engineer and Mine Manager for further Adverse conditions <br />noted in these items should normally be descrih ~@ ~ ~i'J~, ation, volume, etc.) <br />on page two mf this inspection form. OQ ~,~ gGG:9~ <br />.9-9~ <br />