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PERIODIC INSPECTION FORM <br />Water, Sedisent, or Slurry Impoundments <br />INSPECTOR'S NAME: Dennis Jones DATE: 0 <br />NPDES I.D. NO.: CO-0000221 D.P. 004 <br />FACILITY CONFIGURATION: Cross-Valley Pond <br />SITE NAME: South Section 12 Pond #004 <br />MINE NAME: Seneca II Mine (Seneca Coal Co) <br />MINE I.D. NO.: CMLRD Permit No. C-80-005 <br />DATE LAST INSPECTION: ~~~~ ~ <br />LOCATION: SW~/. SEA/. Sec. 12, TSN, R87W <br />LOCATION: 7.1 mi. SE of Hayden, CO <br />OWNER'S REP.: Gregg Kitchen, Gen Mar <br />Circle Or Wrlte in dDDrODrlat0 reSDORSe <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: Yes <br />2. Lift thickness: 12 <br />3. Compaction according to approved plan: Yes <br />4. Burning (specify extent and location): No <br />5. Angle of slope: 5:1 upstream, 2:1 downstream Total = 7:1 <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes: <br /> At isolated points on embankment slopes: Yes No N/A <br /> At natural hillside: Yes No N/A <br /> Over widespread areas: Yes No N/A <br /> From downstream foundation area: Yes No N/A <br /> "Boils" beneath stream or ponded water: Yes No N/A <br />7. Cracks or scarps on crest: Yes No N/A <br />8. Cracks or scarps on slope: Yes No N/A <br />9. Sloughing or bulging on slope: Yes No N/A <br />10. *Maj or erosion problems: Yes No N/A <br />11. Surface movements in valley bottom Or on hillside : Yes NO N/A <br />12. *Erosion of toe: Yes No N/A <br />13. *Water impounded against toe: Yes No N/A <br />14. Existing embankment freeboard: (normal = 4 .9') ~ feet <br />15. Increase Decrease in water level: bto c~.aMy Q <br />- feet <br />16. Cracks, bul in <br />g g, or erosion on upstream face: ~ Yes No N/A <br />17. Visible sumps or sinkholes in slurry surface: <br />18. *Clogging <br /> Spillway channels and pipes: Yes No N/A <br /> Decant system: Yes No N/A <br /> Diversion ditches: Yes No N/A <br />19. *Cracking or crushing of pipes <br /> Spillway pipes: Yes No N/A <br /> Decant system: Yes ® N/A <br />20. Trash racks clear and in place: Yes No N/A <br />*Maj or adverse changes in these items could cause instability and should be reported to the <br />Engineering Manager and Mine Superintendent for further evaluation. Adverse conditions noted in <br />these items should normally be described (extent, location, volume, etc.) in the space on the <br />back of this sheet. <br />