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Forest Service Roads <br /> Inspection Form <br /> Date: 9/1, 1 1 S <br /> Time: 110j-0 — I Z:trv?rr► <br /> Name of Inspector: M.Vc P�ccuG <br /> Current Panel and XC Being Mined: f 7 -?c Pe L -Vf;Z, 15x C. <br /> Road(s) Being Inspected: `D toP�C <br /> Yes No <br /> E] [ 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 /> ❑ M'-- Is there any recent evidence of potential subsidence induced slope <br /> failure? If yes, describe: <br /> ❑ M--' 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 /> WAMCC-Engineering\ENV PERIvETTING\REG AGENCIESTDRMSUnspection-Survey USFS Ponds&Rds\Roads\forest service roads inspection form <br />