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Inspectors Name : -c.SS Q1bk0 Date: 3k .,itt.us.1, -2..g)‘, <br />NPDES ID. No.:CO - 0000213 Date Last Inspected:2 �.,.y1A Zell <br />Facility Configuration: Cross Valley Pond <br />Site Name: Impoundment #007 Location:46N15W SEC 6 <br />Mine Name: New Horizon Mine Location:1 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) (.Y) SE^ No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan CD. No N/A <br />4. Burning (specify extend and location) Yes CI, 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 T N/A <br />b.) At isolated points on embankment slopes: Yes N/A <br />c) At natural hillside: Yes ® N/A <br />d) Over widespread areas Yes ® N/A <br />e) From downsteam foundation area Yes ® N/A <br />f) "Boils" beneath stream or ponded water Yes tra N/A <br />7. Cracks or scarps on crest Yes aml N/A <br />8. Cracks or scraps on slope Yes N/A <br />9. Sloughing or bulging on slope Yes 7� N/A <br />10. Major erosion problems Yes 1�T� N/A <br />11. Surface movements in valley bottom or on hillside Yes N/A <br />12. Erosion of toe Yes N/A <br />13. Water impounded against toe Yes �I N/A <br />14. Existing embankment freeboard (feet) S(o'CO. - ' , U04 . 7,0 Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes Cp N/A <br />16. Visible sumps or sinkholes in slurry surface Yes ® N/A <br />17. Clogging <br />a) Spillway channels and pipes Yes CD. N/A <br />b) Decant system Yes N/A <br />c) Diversion Ditches Yes ® N/A <br />18. Cracking or crushing of pipes <br />a) Spillway pipes Yes Q N/A <br />b) Decant system Yes N/A <br />19. Trash racks clear and in place Ye' No N/A <br />,�o �. ci ► S CV b CA n o.S . S <br />F:\Eng\DATA\WP\pond-banks\DAMFORM.wDd <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />