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.PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: j~.~s G.,~~a Date: [o - 3 - p ~{ - <br />NPDES ID. No.:CO-0000213 007 Date Last Inspecte d: 3 - LS - O <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #007 Location:4 6N15W6 <br />Mine Name: New Horizon Mine Location:2 mi.NW o f Nuc1a. CO. <br /> <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owners Rep.: R L Wade Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE R ESPONSE <br />1. Foundation Prepafation (remoYal of vegetation, stumps., topsoil) Yea tdo N/A <br />2. LifC thickness (iadhea) ~ ~- ~ ~( <br />3. Compaction according to approved plan Ye No N/A <br />4. Horning (specify extaad sad location) - Yee Q N/A <br />5. Angle of slops: 3:1 upstream, 3:1 downstream <br />6. seepage (specify location, color, and approx. volume) <br /> a.) From uaderdraia pipes: Yea ~ NJA <br /> b.) At isolated poinCe on embankment Blopee: Yee [~ N/A <br /> c) At natural hillside: Ye9 ~ N/A <br /> d) Over viidespread areas Yes Q N/A <br /> e) From downateam foundation area Yea ®° N/A <br /> f) °Hoils° beneath etram or ponded water Yee Q N/A <br />7. CreCkB or aCAYpa on Crest YeB ® N/A <br />8. Ciacke or scrape on elope YeB ~I N/A <br />9. Sloughing or~bulging on elope Yea ©o N/A <br />10. Major erosion problems - Yee ® N/A <br />11. Surface movements in valley bottom or on hillside Yas ® N/A <br />1Z. Erosion of toe Yee ,~ N/A <br />13. Water impounded against toe Yes ~ LN~j N/A <br />14. h'xiaCing emban)mheiYt freeboard (feet) ~_` Feet <br />15. Cracks, bulging, .or ~eroeion on upateam face Yea N~ N/A <br />16. .Visible sumps or-.sinkholes in slurry Surface Yee ~ N/A <br />17. Clogging ~ ~- .~. ~~_... <br /> a) Spillway-channels and pipes Yee ~ N/A <br /> b) DecanC system ~ ~' Yee No N{A <br /> c) Diversidn'Ditchea Yes 4o N/A <br />10. Cracking or crushing of pipes <br /> a) Spillway pipes Yea '~ N(A <br /> b) DecanC eystein Ycs ~, N/A <br />19. Trash racks clear and in place ~ No N/n <br />G-3-o~ <br />