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PERIODIC INSPECTION FORM <br />Water, Sediment, or Slurry Impoundments <br />INSPECTOR'S NAME: Dennis Jones <br />NPDES I.D. NO.: CO-0000221 D.P. 012 <br />FACILITY CONFIGURATION <br />SITE NAME: Pond #012 <br />Cross-Valley Pond <br />MINE NAME: Yoast Mine(Seneca Coal Co) <br />MINE; I.D. NO.: CMLRD Permit No. C-94-082 <br />DATE : ?J <br />DATE LAST INSPECTION: I- I o <br />LOCATION: NEl/, NWV4, Sec. 19, TSN, R87W <br />LOCATION: 8.5 mi. SE of Hayden, CO <br />OWNER'S REP.: Roy Karo, Gen Mgr <br />Circle or write in appropriate response <br />1. Foundation preparation (removal of vegetation, stumps, topsoil: Yes <br />2. Lift thickness: 12 in. <br />3. Compaction according to approved plan: Yes <br />4. Burning (specify extent and location): No <br />5. Angle of slope: 3.0:1 upstream, 3.0:1 downstream Total = 6.0:1 <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 No N/A <br />il. Surface movements in valley bottom or on hillside: see belO?J 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 = 9.01) CL_ feet <br />15. Increase Decrease in water level: <br />h It p 4 feet <br />16. - <br />Cracks, bulging, or erosion on upstream face: Yes 42?) N/A <br />17. Visible sumps or sinkholes in slurry surface: N/A <br />18. *Clogging <br /> Spillway channels and pipes: Yes 0 N/A <br /> Decant system: SE?cxi tl_" katy_ ?,.q l,\ g_c, - ? No N/A <br /> Diversion ditches: N/A <br />19. *Cracking or crushing of pipes <br /> Spillway pipes: Yes N/A <br /> Decant system: y?.epeV Yes No N/A <br />20. Trash racks clear and in pla e: Yes N/A <br />21. Discharge rate (gpm) _?R -7 <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. j o w <br />,p C?L , v p d \ C GL L. Ge.9 ci