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PERIODIC <br />WATER, SIDII~]'P, OR SLURRY <br />FORM <br />Inspectors Name : J f ~ ~, Date : `~_ g.- 9G <br />NPDES ID. No.:CO-0000213 006 Date Last Inspected: lZ-(,_ <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #006 Location:47N16W36AC <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla CO. <br />Mine ID No.: C'MLRD Permit #0008-81 <br />Owners Rep.: R. L. Wade, Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stuffs., topsoil) ~ye~ No N/A <br />2. Lift thiclmess (inches) IZ ~ <br />3. Crngaaction according to approved plan ~ N <br />o N/A <br />4. Burning (specify extend and location) Yes '-- <br />~ <br />~rv N/A <br />5. Angle of slope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) Fran underdrain pipes: Yes ~° N/A <br /> b.) At isolated points on embankment slopes: Yes ^ <br />'~' N/A <br /> c) At natural hillside: Yes No N/A <br /> d) Over widespread azeas Yes ~ N/A <br /> e) From downsteam foundation area Yes ~ N/A <br /> f) "Boils" beneath stxam or ponded water Yes N® N/A <br />7. Cracks or acaYps on crest Yes d N/A <br />8. Cracks or scraps on slope Yes ~ N/A <br />9. Sloughing or bulging on slope Yes I~ N/A <br />10. Major erosion problems Yes N/A <br />11. Surface movements in Valley bottom or on hillside Yes I~ N/A <br />12. Erosion of tae Yes ® N/A <br />13. Water impounded against tce Yes ~ N/A <br />14. Existing embankment freeboard (feet) / S ~ Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes cZ1o N/A <br />16. Visible suns or sinkholes in slurry surface Yes ® N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yes --e~ N/A <br /> b) Decant system Yes ~~ N/A <br /> c) Diversion Ditches Yes ~nic N/A <br />1B. Cracking or crushing of pipes <br /> a) Spillway pipes Yes ~ N/A <br /> b) Decant system Yes o N/A <br />19. 'lYash racks clear and in place !`~er~ No N/A <br />~/a 17,sUl.~e <br />PLO RE(,/S,l <br />oP:~EWIS G,Gc°q~ <br />`~ ~;o <br />.Q O/. O <br />ggA~ .~ 2 p~~ <br />FSSlp A1-~G ,/" L <br />