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COUNTY ROAD 33 8~ POWERLINE SUBSIDENCE SURVEY <br />• <br />• <br />DATE: ~" d q'J TIME: <br />WEATHER CONDITIONS: <br />ROAD CONDITIONS <br />CRACKING <br />BUCKLING <br />VISIBLE SETTLING <br />SINK HOLES <br />OTHER <br />MAINTENANCE <br />SHOULDER/FILL CONDITION <br />CRACKING <br />BUCKLING <br />VISIBLE SETTLING <br />SINK HOLES <br />OTHER <br />MAINTENANCE <br />POWERLINE CONDITION <br />LINE INTACT <br />X-ARMS O. K. <br />CHANGE IN SPAN <br />POLE TILTING <br />OTHER <br />MAINTENANCE <br />3%~~Q""lM1 NAME: Rit~ /ni/~" C <br />Fll~n=~- CcGc(,OY PANEL: Q _ ,~i;.~~ <br />1 ~ <br />YES NO COMMENTS <br /> <br />t~Cff C'~~li~L ~/Y1LY1 <br />YES NO COMMENTS <br />/Yv C`~u'C'L~ <br />~- <br />~~ <br />/GhNL <br />YES NO COMMENTS <br />____i~ <br />-~ <br />~, <br />N~ ,{/ciZTfio~' <br /> <br />e:ldocu mentlform slsu bs ide. frm <br />06/07196 <br />