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PERIODIC INSPECTION FORM <br />VOTER, SIDIl~TT, OR SLURRY II~OUNIDMENTS <br />Inspectors Name : wZ, L , G~ bk~ Date <br />NPDES ID. No.:CO-0000213 001 Date Last Inspected: 3-ZI-q ~ <br />Facility Configuration:Cross Valley Pond <br />Site Name: IL~oundment #001 Location: 47N16W36BC <br />Mine Name: New Horizon Mine Location: 2 mi.NW o f Nucl a, CO. <br />Mine ID No.: C'MLRD Permit #0008-81 <br />trwners Rep.: R. L. Wade Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, sturt~s., topsoil) Ye No N/A <br />2. Lift thickness (inches) 1'Z ~ wc.~. <br />3. Cortq~action according to approved plan ~ No N/A <br />4. Burning (specify extend and location) Yes ~ N/A <br />5. Angle of slope: 3~1 upstxeam,~;y downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) Frcxn underdrain pipes: Yes ~ N/A <br /> b.) At isolated points on embankment slopes: Yes ~ N/A <br /> c) At natural hillside: Yes ~ N/A <br /> 3) Oder widespread areas Yes ® N/A <br /> e) From downstream foundation area Yes ~ N/A <br /> f) "Boils" beneath stream or ponded water Yes ~ N/A <br />7. Cracks or scarps on crest Yes ~ <br />~i=7 N/A <br />8. Cracks or scraps on slope Yes No N/A <br />9. Sloughing or bulging on slope Yes ^ <br />`~=7 t1/A <br />10. Major erosion problems Yes ® N/A <br />11. Surface movements in valley bottan or on hillside Yes ~ N/A <br />12. Erosion of tce Yes ®~ N/A <br />13. Water impounded against toe Yes ®, N/A <br />14. Existing embanlanent freeboard (fee[) IZ ~ Feet <br />15. Cracks, bulging, or erosion on upstream face Yes ® N/A <br />16. visible sunms or sinkholes in slurry surface Yes ~ N/A <br />17. Clogging <br /> a) Spillway channels and pipes Yes ® N/A <br /> b) Decant system Yes ® N/A <br /> c) Diversion Ditches Yes Qom N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes bl N/A <br /> b) Decant system Yes ® N/A <br />19. Trash racks clear and in place ~ No N/A <br />7-Z3' q ~ <br />