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1 q 1 <br />Inspectors Name: (- i �'�` Date: l -I H 2 <br />NPDES ID. No.:CO- 0000213 <br />Facility Configuration: Cross Valley Pond <br />Site Name: Impoundment #007 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.: Rick Wolney, Mine Manager <br />CIRCLE OR WRITE IN APPROPRIATE RESPONSE <br />1. <br />2. <br />3. <br />4. <br />Foundation Preparation (removal of vegetation, stumps., topsoil) <br />Lift thickness (inches) <br />Compaction according to approved plan Yes No N/A <br />Burning (specify extend and location) Yes q 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 No N/A <br />c) At natural hillside: Yes No N/A <br />d) Over widespread areas Yes No N/A <br />e) From downsteam foundation area Yes No N/A <br />f) "Boils" beneath stream or ponded water Yes N N/A <br />7. Cracks or scarps on crest Yes N/A <br />8. Cracks or scraps on slope Yes No N/A <br />9. Sloughing or bulging on slope Yes Io N/A <br />10. Major erosion problems Yes N/A <br />11. Surface movements in valley bottom or on hillside Yes I moo} 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 (feet) Iiil5 — Q. ct (0,45 Feet <br />15. Cracks, bulging, or erosion on upsteam face Yes ltd N/A <br />16. Visible sumps or sinkholes in slurry surface Yes Nod N/A <br />17. Clogging <br />a) Spillway channels and pipes Yes N N/A <br />b) Decant system Yes (Io N/A <br />c) Diversion Ditches Yes No N/A <br />18. Cracking or crushing of pipes <br />a) Spillway pipes Yes Q N/A <br />b) Decant system Yes <br />Y e°s <br />19. Trash racks clear and in place <br />F: \ENG \DATA \WORD \POND - BANKS \DAMFORM.DOCDOC <br />WATER, SEDIMENT, OR SLURRY IMPOUNDMENTS <br />vut <br />PERIODIC INSPECTION FORM <br />Date Last Inspected: t3 4/d/ 2.0 2- <br />No N/A <br />?.� r►' A cr,cAA 1.3 <br />