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• Forest Service Roads <br />Inspection Form <br />• <br />• <br />Date: `�'(,Z t/ It <br />Time: i a . vv �. <br />Name of Inspector: 2 . �,., c -a1 <br />Current Panel and XC Being Mined: 4.3- G I <br />Road(s) Being Inspected: 0 er F,, r <br />Yes No <br />Notes: <br />❑ Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes, ,which road(s): <br />Y For <br />• Are there visible surface cracks on the road? If yes, describe <br />(location, width, length, etc.): <br />'Is there any recent evidence /of Iot n 'al subsidence induced slope <br />failure? If yes, describe: <br />e there any other potentially damaging, subsidence induced <br />fetures on or near the road? If yes, describe: <br />❑ Is miti tion needed? If yes, list suggestions: <br />TC6 PA nG () .cc4hs <br />Signature of Inspector: <br />* If a n y potential subsidence indu , : • features are observed that could cause harm <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately. <br />