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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Dennis Jones DATE: L- z <br />NPDES I.D. NO.: N/A <br />FACILITY CONFIGURATION: Cross-Valley Pond DATE LAST INSPECTION: <br />SITE NAME: Pond #012A LOCATION: NEIA NEB/a,Sec. 19, T5N, R87W <br />MINE NAME: Yoast Mine(Seneca Coal Co) LOCATION: 8.5 mi. SE of Hayden, CO <br />MINE I.D. NO.: CMLRD Permit No. C-94-082 OWNER'S REP.: Roy Karo, Gen Mar <br />Circle or write in appropriate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: _ Yes <br />2. Lift thickness: _ in. <br />3. Compaction according to approved plan: Yes <br />4. Burning (specify extent and location): No <br />5. Angle of slope: upstream, downstre am Total = <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes: Yes No N/A <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. *Major erosion problems: Yes N N/A <br />11. Surface movements in valley bottom or on hillside: Yes N N/A <br />12. *Erosion of toe: Yes N N/A <br />13. *Water impounded against toe: Yes N/A <br />14. Existing embankment freeboard: ?t- n 4 'J ern iw bpi feet <br />15. Increase Decrease in wa?dr level: feet <br />16. Cracks, bulging, or erosion on upstream face: Yes No N/A <br />17. Visible sumps or sinkholes in slurry surface: N/A <br />18. *Clogging <br /> Spillway channels and pipes: Yes No N/A <br /> Decant system: <br /> Diversion ditches: N/A <br />19. *Cracking or crushing of pipes <br /> Spillway pipes: Yes No N/A <br /> Decant system: N/A <br />20. Trash racks clear and in place: Yeso N/A <br />21. Discharge rate (gpm) <br />*Major adverse changes in these items could cause instability and should be reported to <br />the Engineering Manager and Mine Superintendent for further evaluation. Adverse <br />conditions noted in these items should normally be described (extent, location, volume, <br />etc.) in the space on the back of this sheet. <br />?pICA :DLIN- <br />1 J <br />t? d w cX G © fA. l?2 <br />l.`,6 4 V LA- c_4 o L-,-