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Forest Service Roads <br />Inspection Form <br />Date: <br />Time: 10 Ito pio <br />Name of Inspector: <br />Current Panel and XC Being Mine <br />Road(s) Being Inspected: J a r X C 30 <br />Dr y Fo r v-. <br />Yes No <br />? Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes, which road(s): <br />?r <br />? Are there visible surface cracks on the road? If yes, describe <br />(location, width, length, etc.): <br />k 11 <br />I <br /> <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 />Notes: <br />?' Is mitigation needed? If yes, list suggestions: <br /> <br />Signature of Inspector: <br />* If any potential subsidence i duce fea es are observed that could cause harm <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately.