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Forest Service Roads <br />Inspection Form <br />Date: 3 (? ?'t t <br />Time: <br />Name of Inspector: <br />Current Panel and XC Being Mined: <br />Road(s) Being Inspected: pr Y F o "k- <br />Yes No <br />PC ? Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes,v*ch road(s) <br />0 r v ?hr- <br />Are there visible surface cracks on the road? If yes, describe <br />(location, width, length, etc.): <br />Is there any recent evidence of o nti 1 su Lidence induced slope <br />failure? If yes, describe: <br />0 Fl 11 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 />In A&ucss, ?? <br />Signature of Inspector: 4ee * If any potential subsidence induced fea Z that could cause harm <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately.