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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Dennis Jones DATE: 6--3,0-6 <br />NPDES I.D. NO.: N/A <br />FACILITY CONFIGURATION: Cross-Valley Pond DATE LAST INSPECTION: 3' 0q <br />-t <br />SITE NAME: Pond #012A LOCATION: NE% NE1/a,Sec. 19, T5N, R87W <br />MINE NAME: Yoast Mine(Seneca Coal Co) LOCATION: 8.5 mi. SE of Havden, 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, downstream Total = <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes: Yes o <br /> At isolated points on embankment slopes: Yes No <br /> At natural hillside: Yes No <br /> over widespread areas: Yes No <br /> From downstream foundation area: Yes No <br /> "Boils" beneath stream or ponded water: Yes No <br />7. Cracks or scarps on crest: Yes No <br />8. Cracks or scarps on slope: Yes No <br />9. Sloughing or bulging on slope: Yes No <br />10. *Major erosion problems: Yes No <br />11. Surface movements in valley bottom or on hillside: Yes No <br />12. *Erosion of toe: Yes No <br />13. *Water impounded against toe: Yes N <br />14. Existing embankment freeboard: (4.6' when full) 13- feet <br />15. Increase Decrease in water level: feet <br />16. Cracks, bulging, or erosion on upstream face: Yes No <br />17. Visible sumps or sinkholes in slurry surface: N/A <br />18. *Clogging <br /> Spillway channels and pipes: Yes 0 <br /> Decant system: N/A <br /> Diversion ditches: N/A <br />19. *Cracking or crushing of pipes <br /> Spillway pipes: Yes <br /> Decant system: N/A <br />20. Trash racks clear- and in p ace: es No <br />21. Discharge rate (gpm) (w]4 ?2V ?eV qx . ?ee? bG ?oc.? :,S clti?.?y 0 <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <br />N/A <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 />kA 4 <br />JAeeJ ct., oU.9-