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<br />PERIODIC INSPECTION FORM <br />WATER, SIDINiENT, OR SLURRY <br />Inspectors Name : jZ , L , ~~)(o~ Date : 1 1- /9• g ti <br />NPDES ID. No.:CO-0000213 006 Date Last Inspected: q-/ 5-9 ? <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #006 Location:4 7N16W36AC <br />Mine Name: New Horizon Mine Location:2 mi.NW o f Nucl a, CO. <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owners Rep.: R. L. Wade Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE <br />R ESPONSE <br /> ti <br />1. Foundation Preparation (removal of vegetation, stur~s., topsoil) ® No N/A <br />2. Lift thic'~cness finches) <br />3. Cowaction according to approved plat _ ~ No N/A <br />4. Burning (specify extend and location) Yes @ N/A <br />5. Angie of slope: 3'1 upstream, 3~1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) From underdra in pipes: Yes '~ N/A <br /> b.) At isolated points on embanlmient slopes: Yes ® N/A <br /> c) At natural hillside: Yes ~ N/A <br /> d) Over widespread areas Yes ~ N/A <br /> e) Frcm downstream foundation area YES ~' N/A <br /> f) "Boils" beneath scream or ponded water Yes ® N/A <br />7. Cracks or scarps on CYESt Yes ~ N/A <br />8. Cracks or scraps on slope Yes ® 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 bottom or on hillside Yes ® N/A <br />12. Erosion of tce Yes ~° N/A <br />13. Water irt~ounded against tce Yes ~ 7ry N/A <br />14. Existing embankment freeboard (feet) _~ Feet <br />15. Cracks, bulging, or erosion on upstream face _ Yes ® N/A <br />16 Visible surtq~s or sinkholes in slurry surface Yes ® [J/A <br />17. Clogging <br /> a) Spillway channels and pipes Yes ® N/A <br /> b) Decant system- Yes ~ N/A <br /> c) Diversion Dit ches_ Yes ~1 N/A <br />18. Cracking or crushing of pipes <br /> a) spillway pipes- Yes ® N/A <br /> b) Lk cant system- Yes ~ N/A <br />19. Trash racks clear and in place ~ No N/A <br />.rC 1'l0'I YtS CMGr41M~ <br /> <br />