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PERIODIC INSPECTION FORM <br />L~.TER, SIDII~N'P, OR SLURRY Il~OLiDIDT'IEN'PS <br />Inspectors Name : ~ , t_ _ ~' ..b`f~a Date : 7 _ ZS- °17 <br />NPDES ID. No.:CO-0000213 007 Date Last Inspected: ~-t-I-9 l <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #007 Location:47N15W6 <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla S2 <br />Mine ID No.: CMLRD 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, stumps., topsoil) ~ No N/A <br />2. Lift thickness (inches) /~ /Nr/~. <br />3. Compaction according to approved plan Y® No N/A <br />4. Burning (specify extend and location) Yes ~ N/A <br />5. Angle of slope: 3~1 upstream, ~l 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 ~ N/A <br /> c) At natural hillside: Yes ~ N/A <br /> d) Over widespread areas Yes ~ N/A <br /> e) From downstream foundation area Yes ® N,/A <br /> f) "Boils" beneath scream or ponded water Yes ® N/A <br />7. Cracks or scarps on crest Yes ~y N/A <br />8. Cracks or scraps on slope Yes ~ N/A <br />9. Sloughing or bulging on slope Yes ~o N/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 tae Yes ® N/A <br />13. Water i~ounded against tce Yes ® <br />i N/A <br />14. Existing embvJanent freeboard (feet) ~ _ Feet <br />15. Cracks, bulging, or erosion on upstream face Yes N/A <br />16. Visible sumps 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 ® N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes ~ N/A <br /> b) Decant system Yes ® N/A <br />19. Trash racks clear and in place Ye No N/A <br />7-~~~~ <br />