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• Forest Service Roads <br />Inspection Form <br />• <br />• <br />Date: 3 / /" <br />< <br />Time: 1:00 A-A- <br />Name of Inspector: 4. 5 p+e 10 0 ,9 <br />Current Panel and XC Being Mined: . Xc ae <br />Road(s) Being Inspected: �� r), f or k,._ <br />Yes No <br />❑ <br />❑ ❑ <br />Notes: <br />Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes, which road(s): <br />r Y <br />El 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 />0 <br />f <br />Signature of Inspector: <br />If any potential subsidence educed eatures -are obsfiv ed that could cause harm <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately. <br />