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• <br />Yes No <br />❑ ❑ <br />❑ <br />Notes: <br />Forest Service Roads <br />Inspection Form <br />Date: 3(Vt <br />Time: W O O / <br />Name of Inspector: g. 5 ° <br />Current Panel and XC Being Mined: £ i kG ae2 <br />Road(s) Being Inspected: O y �o r� <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 />.Nod aca4 <br />ti0L ro <br />Signature of Inspector: <br />* If any potential subsidence induce ;,{eatures are( ► erve,th_ai could cause ann <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately. <br />