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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name: _ -%~~,SS ~~ICG Date: ~- /7_ 03 <br />NPDES ID. No.:CO-0000213 007 Date Last Inspected: l - 9 D3 <br />Facility Configuration:Cross Valley Pond <br />Site Name: Impoundment #007 Location:46N15W6 <br />Mine Name; New Horizon Mine Location:2 mi.NW of Nucla, CO. <br />Mine ID No.: CMLRD Permit #0008-81 <br />Owne rs Rep.: R. L. Wade. Mine Manager <br /> CIRCLE OR WRITE IN APPROPRIATE RESP ONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) ~ No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan Ye No N/A <br />9. Burning (specify extend and location) Yee No N/A <br />5. Angle of elope: 3:1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a.) From underdrain pipes: Yes !~ N/A <br /> b.) At isolated points on embankment elopes: Yea ® N/A <br /> c) At natural hillside: Yee ~ N/A <br /> d) Over widespread areas Yes ~ N/A <br /> e) FTOm dOWnatedm fennddtiOn dreg Yee V N/A <br /> f) "BOils~~ beneath atram or ponded water Yea ® N/A <br />7. Cracks or scarps on crest Yes ~ N/A <br />e. CYaCks Or scrape On elope Yea ~ N/A <br />9. Sloughing or bulging on elope Yea ® N/A <br />10. Major erosion problems _ Yee ® N/A <br />11. Surface movements is valley bottom or On hillside Yee ~ N/A <br />12. Erosion of toe Yes ® N/A <br />13. Water impounded against toe Yee ~® N/n <br />14. Existing embankment freeboard (feet) _2 _ Feet <br />15. Cracks, bulging, or erosion on upateam face Yea ~ <br />1 <br />C11 N/A <br />16. Visible sumps or sinkholes in Blurry surface Yee Eo N/A <br />17. Clogging - <br /> a) Spillway channels and pipes Yee ~ N/A <br /> b) Decant eyetem - Yes ~ N/A <br /> C) Diveieion Ditches Yea ~ N/A <br />16. Cracking or crushing of pipes <br /> a) Spillway pipes Yea ~ N/A <br /> b) Decant eyetem Yea ~ N/A <br />19. Trash racks clear and in place Ye No N/A <br />9--~7-~3 <br />