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Inspectors Name: R., 5 G0,bk,. Date: - \\ <br />NPDES ID. No.:CO - 0000213 Date Last Inspected: - 511Ay \� <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) No N/A <br />2. Lift thickness (inches) <br />3. Compaction according to approved plan No N/A <br />4. Burning (specify extend and location) Yes . 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.) At isolated points on embankment slopes: Yes (2:› N/A <br />c) At natural hillside: Yes 4ER 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 ® N/A <br />7. Cracks or scarps on crest Yes ® N/A <br />8. Cracks or scraps on slope Yes ® N/A <br />9. Sloughing or bulging on slope Yes ® N/A <br />10. Major erosion problems Yes 0 N/A <br />11. Surface movements in valley bottom or on hillside Yes �j N/A <br />12. Erosion of toe Yes N/A <br />13. Water impounded against toe Yes ® N/A <br />14 . Existing embankment freeboard (feet) 546v . Z, - 5(e 3a, `� ( 9 ,c E Q Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes N/A <br />16. Visible sumps or sinkholes in slurry surface Yes ED N/A <br />17. Clogging <br />a) Spillway channels and pipes <br />b) Decant system <br />c) Diversion Ditches Yes 0 N/A <br />18. Cracking or crushing of pipes <br />a) Spillway pipes Yes 0 N/A <br />b) Decant system Yes ® N/A <br />19. Trash racks clear and in place GI No N/A <br />Por., 1 s •s c' \r 1 <br />(N,tg -•A cv� • <br />J a-,RC j t K C ev M <br />F: \Eng \DATA \WP pond- banks \DAMFORM.wpd <br />PERIODIC INSPECTION FORM <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />Yes ® N/A <br />Yes N/A <br />7No-J 20 <br />