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Forest Service Roads <br /> Inspection Farm <br /> Date: /2 <br /> Time: /: <br /> Name of Inspect: lw,ee <br /> Current Panel and XC Being Mined: j�� el&' <br /> Road(s) Being Inspected: PAY T-Op k! -Peer CPee) - <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: � d1C d�t �� 5WIP tJ QCZ�S @�cP'�pc�Y� /R/./C'C'ess� <br /> o I1Yi/40V f}A-�p/ /1 p A d <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 PERMITTING\REG AGENCIES\CDRMS\Inspection-Survey USFS Ponds&Rds\Roads\forest service roads inspection form <br />