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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name : ~„ ~ ~ ~,}~ Date : 5 - o$ , o G <br />NPDES ID. No.:CO-0000213 Date Last Inspected: 0 3 - (¢_p 6 <br />Facility Configuration: Cross Valley Pond - <br />Site Name: Impoundment #007 Location:46N15W 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 Manaaer <br />1 <br />2 <br />3 <br />4 <br />5 <br />6 <br />7. <br />B. <br />9. <br />10 <br />11 <br />12 <br />13 <br />24 <br />15 <br />16 <br />17 <br />18 <br />19 <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />Foundation PreparaCion (removal of vegetation, stumps., topsoil) Yes No N/A <br />Lift thickness (inches) <br />Compaction according to approved plan ~ No N/A <br />Burning (specify extend and location) Yes ~ N/A <br />Angle of slope: 3;1 upstream, 3;1 downstream <br />Seepage (specify location, color, and approx. volume) <br />a ) From d d <br />un er rain pipes: Yes <br />b•) At isolated points on embanlorteat slopes: ~ Yea <br />c) At natural hillside: Yes <br />d) Over xidespread areas Yea <br />el From downsteam foundation azea Yes ~o <br />f) "Boils" beneath straw or ponded water Yes <br />Cracks or scarps on crest Yes <br />Cracks or scraps on slope Yes <br />Sloughing or bulging on slope Yes i~q <br />Major erosion problems Yes Sin <br />Surface movements in valley bottom or on hillside Yes ~ <br />ELOalen O£ tce <br /> Ye6 <br />Water impounded against toe Yes 4A• <br />Existing embankment freeboard (feet) 1 1\ <br />Cracks, bulging, or erosion on upsteam face Yea- <br />Visible sumps or sinkholes in slurry surface Yes ~9 <br />Clogging <br />a) - Spillway channels and pipes Yea <br />b) Decant system <br /> Yea <br />c) Diversion Ditches <br /> Yes <br />Cracking or crushing of pipes <br />a) Spillway pipes Yea <br />b) Decant system <br /> Yes <br />Trash racks clear and in place ye <br />~OY~C~1 3S y~$v~Ot 4 ~R <br />F:\Eng\DATA\Wp\pond-banks\DAMFORM.wpd <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />Feet <br />N/A <br />N/A <br />® N/A <br />~[ N/A <br />N/A <br />N/A <br />N/A <br />NO N/A <br />D,S oa_ oG <br />