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Forest Service Roads <br />Inspection Form <br />Date: ID/I113 <br />Time: /•'00 <br />Name of Inspector: �- <br />Current Panel and XC Being Mined: 6'1 <br />Road(s) Being Inspected: <br />" — Alb /It <br />Yes No <br />❑ Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes, which road(s): <br />❑ Are there visible surface cracks on the road? If yes, describe <br />(location, width, length, etc.): <br />❑ ❑ Is there any recent evidence of potential subsidence induced slope <br />failure? If yes, describe: <br />❑ ❑ Are there any other potentially damaging, subsidence induced <br />features on or near the road? If yes, describe: <br />❑ ,❑ Is mitigation needed? If yes, list suggestions: <br />Notes: -- nn, p - n <br />�l/G � °� aL�l L'1� �/i /�G � k)o'll � of t / Gf <br />filt'WA417 I/ lee <br />vi JAI <br />Signature of Inspector: <br />* If any potential subsidence induced features are observed that could cause harm <br />to the public or operations, notify Jessica Loveland or Mike Peacock immediately. <br />