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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Dennis Jones DATE: 6-N-09 <br />NPDES I.D. NO.: CO-0000221 D.P. 013 / <br />a L(.? <br />3 <br />FACILITY C ONFIGURATION: Cross-Valley Pond DATE LAST INSPECTION: ' <br />SITE NAME: Pond #013 LOCATION: SEA/a NWY4, 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 as»rox)riate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: _ Yes <br />2. Lift thickness: in. <br />3. Compaction according to approved plan: <br />4. Burning (specify extent and location): No <br />5. Angle of slope: _ 3:1 upstream, 3:1 downstream To tal = 6:1 <br />6. *Seepage (specify location, color, and approximate volume) <br /> From underdrain pipes: N/A <br /> At isolated points on embankment slopes: Yes F <br />0 <br />1 N/A <br /> At natural hillside: Yes - <br />- 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 N/A <br />7. Cracks or scarps on crest: Yes N/A <br />8. Cracks or scarps on slope: Yes U N/A <br />9. Sloughing or bulging on slope: Yes No N/A <br />10. *Major erosion problems: Yes N/A <br />11. Surface movements in valley bottom or on hillside: See- 04"-S ' Yes No N/A <br />12. *Erosion of toe: Yes N/A <br />13. *Water impounded against toe: Yes No N/A <br />14. Existing embankment freeboard: (normal = 41) q <br />.L feet <br /> - <br />15. Increase ? Decrease in water level: 0L 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 N N/A <br /> Decant system: N/A <br /> Diversion ditches: Yes (Do N/A <br />19. *Cracking or crushing of pipes <br /> Spillway pipes: Yes N/A <br /> Decant system: N/A <br />20. Trash racks clear and in place: Yes No N/A <br />21. Discharge rate (gpm) le-%)-el q ( 6--Q4 io ow S a? n <br /> m cckt,jear 4 seep < a o?.??:h <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 , volu me, <br />etc.) in the space on the back of this sheet. <br />