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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name : ??4s k Date: p 3 lac v ?,?. OR, <br />NPDES ID. No.:CO-0000213 Date Last Inspected: o-L peg c3 <br />Facility Configuration: Cross Valley Pond <br />Site Name: Impoundment #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 Manager <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE, <br />1. Foundation Preparation (removal of vegetation, stumps., topsoil) Ye No N/A <br />2. Lift thi kn <br /> s ess (inches) <br />3. Compaction according to approved plan <br />e© <br />No <br />N/A <br />4• Burning (specify extend and location) <br />Yes <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: <br />Yes <br />? <br />N/A <br /> b.) At isolated points on embankment slopes: <br /> <br />c) At natural hillside: Yes o N/A <br /> <br />d) Over widespread areas Yes ® N/A <br /> <br />e) From downsteam foundation area Yes 1LTo? N/A <br /> <br />f) "Boils" beneath stram or ponded water Yes N/A <br /> <br />7. <br />Cracks or scarps on crest Yes ? N/A <br /> <br />S. <br />Cracks or scraps on slope Yes ? N/A <br /> <br />9. <br />Sloughing or bulging on slope Yes 40 N/A <br /> <br />10. <br />Major erosion problems Yes N/A' <br /> <br />11. <br /> <br />12 <br />Surface movements in valley bottom or on hillside Yes <br /> <br />Yes (0 N/A <br /> <br />N/A <br />. Erosion of toe <br /> <br />13. <br />Water impounded against toe Yes <74-9 N/A <br /> <br />14. <br />Existing embankment freeboard (feet)_ 'JG3 Yes <br />Z- r, QJg N/A <br /> <br />is. <br />Cracks, bulging, or erosion on upsteam face --L-1, <br /> <br />Yes - <br />d^? Feet <br /> <br />N/A <br />16. Visible sumps or sinkholes in slurry surface N <br /> <br />17. <br />Clogging Yes N N/A <br /> a) Spillway channels and pipes Y <br /> <br />b) Decant system es <br /> <br />Yes <br /> <br />? N/A <br /> <br />N/A <br /> C) Diversion Ditches <br /> <br />18. <br />Cracking or crushing of pipes Yes N/A <br /> a) Spillway pipes <br /> <br />b) Decant system Yes <br /> <br />Yes (ff6 <br /> <br />? N/A <br /> <br />N/A <br />19. Trash racks clear and in place <br />Ye <br />No <br />N/A <br />t. `t C) 1.y C- k a in .? <br /> DO REG /S <br /> p?? EWtS? ? rFq <br /> <br /> <br />F: \E n DATA\WP <br />9\ \pond-banks\DAMFORM.wpd <br /> <br /> ?` IONAL