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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name : -'Co~ ~,~ ~,~ Date :_ -Z,d tea` 0`1 <br />NPDES ID. No.:CO-0000213 Date Last Inspected:~.h p~,_ 01 <br />Facility Configuration: Cross Valley Pond "~~-' <br />Site Name: Imt~oundment #007 Location:46N15W SEC 6 <br />Mine Name: New Horizon Mine Location:l mi.NW of Nucla CO. <br />Mine ID No.; CDMG Permit #0008-81 <br />Owners Rep.; R. L. Wade Mine Mana er <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) ~ No N/A <br />2. Lift thi kn <br /> c ess (inches) <br />3• Compaction according to approved plan <br /> <br />4. <br />Burning (specify extend and location) ~. <br /> <br />Yes No <br /> <br />®o N/A <br /> <br />N/A <br /> <br />5. <br />Angle of slope: 3:1 upstream, 3:1 downstream . <br />6. Seepage (specify location, color, and approx. volume) <br /> a•) From underdrain pipes: Yes ® <br /> <br />b•) At isolated points on embankment slopes: <br />Yes , <br />Q N/A <br />N/A <br /> c) At natural hillside: <br /> <br />d) Over widespread areas Yes ® N/A <br /> <br />e) From downsteam foundation area Yes N/A <br /> <br />f) "Boils" beneath strain or ponded water Yes <br /> <br />Yes <br /> <br />® N/A <br /> <br />N/A <br />7. Cracks or scarps on crest <br /> <br />8. <br />Cracks or scraps on slope Yes N/A <br /> <br />9. <br />Sloughing or bulging on slope Yes ~ N/A <br /> <br />10. <br />Major erosion problems Yes ~ N/A" <br /> <br />11. <br />Surface movements in valley bottom or on hillside Yes ® N/A <br /> <br />12. <br />Erosion of toe Yes N/A <br /> <br />13. <br />Water impounded against toe Yes ~ N/A <br /> <br />14. <br />Existing embankment freeboard (feet) Yes <br />/ ® <br />~ N/A <br /> <br />15. <br />Cracks, bulging, or erosion on upsteam face --lg - Feet <br /> <br />16. <br />Visible sumps or sinkholes in slurry surface Yes. <br /> <br />Y N/A <br /> <br />17. <br />Clogging es N/A <br /> a) Spillway channels and pipes <br />Yes <br />~ <br />N/A <br /> b) Decant system <br /> <br />c) Diversion Ditches Yes ® N/A <br /> <br />18. <br />Cracking or crushing of pipes Yes ~ N/A <br /> a) Spillway pipes <br />Yes <br />N/A <br /> b) Decant system <br /> <br />19. <br />Trash racks clear and in place Yes <br />~ ® N/A <br /> ~.:~ No N/A <br />~a~a ,~ ~,sa~.a~~.~,.~ <br />F:\Eng\DATA\WP\pond-banks\DAMFORM.wpd <br />., <br />o ~ 9 <br />P ~'"~~S cs'~ <br />-, G~';~o <br />. ~9 <br />,, ..:. . <br />10NAL~~ p~ <br />~ 1~~ <br />