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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Micha 7 A7 av'77a DATE: 09/2597 <br />NPDES I.D. NO.: cO-0000227 ^.P. 008 <br />FACILITY CONFIGURATION: Croce-Valley Pond DATE LAST INSPECTION: ~1~27/97 <br />SITE NAME: Pond 1008 LOCATION: sWh NW'y Sec. 7 TcN. R86W <br />MINE NAME: S n a TT Min (c n a oa7 07 LOCATION: 7.7 mi. c. o Hayden. cO <br />MINE I.D. NO.: CMT.Rn Permit No. C-80-005 OWNER'S REP.: Brad Rrown. Gen Mg~_ <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: es No N/A <br />2. Lift thickness: ~_ in. N/A <br />3. Compaction according to approved plan: es No N/A <br />4. Burning (specify extent and location): Yes No <br />5. Angle of elope: 3:1 upstream, 3:1 downstream Total = 6:] N/A <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes: Yes No <br /> At isolated points on embankment slopes: Yes ® N/A <br /> At natural hillside: Yes ® N/A <br /> Over widespread areas: Yes ® N/A <br /> From downstream foundation area: Yes o N/A <br /> "Boils" beneath stream or ponded water: Yes o N/A <br />7. Cracks or ecarpa on crest: Yea ® N/A <br />B. Cracks or ecarpa on elope: Yes N/A <br />9. Sloughing or bulging on elope: Yes ~ N/A <br />10. *Major erosion problems: Yes ~ N/A <br />11. Surface movements in valley bottom or on hillside: Yes ~ N/A <br />12. *Eroaion of toe: Yee ® N/A <br />13. *Water impounded against toe: Yes ~ N/A <br />14. Existing embankment freeboard: see comments 8.0 feet <br />15. Increase Decrease in water level: No change feet <br />16. Cracks, bulging, or erosion on upstream face: Yee No N/A <br />17. Visible sumps or sinkholes in Blurry surface: Yes No <br />18. *Clogging <br /> Spillway channels and pipes: Yes ®° N/A <br /> Decant sy at em: Yes No <br /> Diversion ditches: Yes No A <br />19. *Cracking or crushing of pipes <br /> Spillway pipes: Yes Qo N A <br /> Decant system: Yes No A <br />20. Trash racks clear and in place: ee No N/A <br />*Major adverse changes in these items could cause instability and should be reported to the <br />Engineering Manager and Mine Superintendent for further evaluation. Adverse conditions noted <br />in these items should normally be described (extent, location, volume, etc.) in the apace on <br />the back of this sheet. <br />