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PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Inspectors Name:S? F`.? Date: Ib Klog ZptD <br />NPDES ID. No.:CO-0000213 Date Last Inspected: ia <br />Facility Configuration:-Cross Valley Pond <br />Site Name: Impoundment 4007 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) Yes No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan Ye No N/A <br />4. Burning (specify extend and location) <br />Yes <br />? <br />N/A. <br />5. Angle of slope: 3.1 upstream, 3:1 downstream <br />6. Seepage (specify location, color, and approx. volume) <br /> a•) From underdrain pipes: Yes ® N/A <br /> b.1 At isolated points on embankment slopes: Yes N/A <br /> c) At natural hillside: <br /> <br />d) Over widespread areas Yes ® N/A <br /> <br />e) From downsteam foundation area Yes <br />Yes i? <br />® N/A <br />N/A <br /> f) "Boils" beneath stram or ponded water Yes (:0 N/A <br />7. Cracks or scarps on crest <br />Yes <br />Q <br />N/A <br />8. Cracks or scraps on slope <br />Yes <br />4V <br />N/A <br />9. Sloughing or bulging on slope <br />Yes <br />Q <br />N/A' <br />10. Major erosion problems <br /> <br />11. <br />Surface movements in valley bottom or on hillside Yes <br /> <br />Yes ® <br /> <br />® N/A <br /> <br />N/A <br />12. Erosion of toe <br /> <br />13. <br />Water impounded against toe Yes 90 N/A <br /> <br />14. <br />Existing embankment freeboard (feet) <br />15(.4-1R_ 2 44U " Yes (Q? <br /> <br />is <br />I <br />-7 N/A <br /> <br />15. -_. <br />Cracks, bulging, or erosion on upsteam face . <br /> <br />Yes <br /> <br />® Feet <br /> <br />N/A <br />16. Visible sumps or sinkholes in slurry surface <br />Yes <br />®o, <br />N/A <br />17• Clogging <br /> a) Spillway channels and pipes Yes N/A <br /> b) Decant system Yes ?I N/A <br /> c) Diversion Ditches Yes ® N/A <br />18. Cracking or crushing of pipes <br /> a) Spillway pipes Yes N/A <br /> b) Decant system Yes <br /> <br />19. <br />Trash racks clear and in place N/A <br /> No N/A <br />?p? 1 5 N oT N---) I'sCA.v. <br />F:\Eng\DATA\WP\pond-banks\DAMFORM.wpd <br />RE /S:R4 <br />ovf??? iNI G,G?9 <br />cr <br />'O <br />/p