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PERIODIC <br />WATER, SIDII~[dP, OR SLURRY <br />FORM <br />Inspectors Name: ~a~ ~V~,1(q Date: g_-z,~.q` <br />NPDES ID. No.:CO-0000213 007 Date Last Inspected: (0.7.[_ Q ~ <br />Facility Configuration:Cross Vallev Pond <br />Site Name: Impoundment #007 Location:47N15W6 <br />Mine Name: New Horizon Mine Location:2 mi.NW of Nucla, CO. <br />Mine ID No.: QKLRD Permit #0008-81 <br />Owners Rep.: <br /> CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (remo~ral of vegetation, stumps., topsoil) Ye No N/A <br />2. Lift thickness (inches) ~ Z i N~ <br />3. Cortiaction according to approved plan ~ No N/A <br />4. Burning (specify extend and location) Yes ~ N/A <br />5. Angle of slope: ~;~ upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. wlume) <br /> a.) From underdrain pipes: Yes ® N/A <br /> b.) At isolated points on embanlurent 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 ® N/A <br />8. Cracks or scraps on slope Yes n <br />~~ <br />gyp N/A <br />9. Sloughing or bulging on slope Yes ~ 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 tce Yes ~ N/A <br />13. Water inq~ounded against tce Yes ~ N/A <br /> <br />14. <br />6ci sting emL~nlmient freeboard (feet) <br />~ t <br />_ <br />Feet <br />15. Cracks, bulging, or erosion on upstream face Yes ~ N/A <br />16. Visible sunq~s 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 crnshing of pipes <br /> a) Spillway pipes Yes ~ N/A <br /> b) Decant system Yes ® N/A <br />19. Trash racks clear and in place ~ No N/A <br />i ~p AEGIS <br />r~~-,~NIS'~'~s~Fq~ <br />iU " I:iS• <br />~~sioNa.~E`'~ g ~.4~ <br />