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Forest Service Roads <br />Inspection Form <br />Date: V (l'( (( <br />Time: 6:6t e ^ <br />Name of Inspector: <br />Current Panel and XC Being Mined: 1.,2- xC3d <br />Road(s) Being Inspected: pq <br />Yes No <br />i ? Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes, which road(s): <br />D ?^ y Eo <br />? Are there visible surface cracks on the road? If yes, describe <br />(location, width, length, etc.): <br />A ? ? 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: <br />s/VDtAI Cpl/E12-? LnGC?SS)b?e <br />Signature of Inspector:_ atul <br />* If any potential subsidence induce r observed that oo cause harm <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately.