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Date: /'P /I 3/1 8 <br />Time: 11:gSa-"- <br />Forest Service Roads <br />Inspection Form <br />Naive of Inspector: Y1A( K t +�--Ac- <br />Current Panel and XC Being Mined: Z7 ?ct-flea-- <br />Road(s) Being Inspected: —3�,r y 1, k <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 />❑ Lam' Is there any recent evidence of potential subsidence induced slope <br />failure? If yes, describe: <br />❑ R'-'/ 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: <br />Signature of Inspector: <br />* If any potential subsidence induced features are observed that could cause harm <br />to the public or operations, notify Mike Peacock or Kathy Welt immediately. <br />W:\MCC-Engineering\ENV PERMITTING\REG AGENCIES\CDRMS\Inspection-Survey USFS Ponds & Rds\Roads\forest service roads inspection form <br />