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Forest Service Roads <br />Inspection Form <br />• <br />Date: >73/ I <br />Time: , S <br />Name of Inspector: g, S geie tea od <br />Current Panel and XC Being M ined: 2 v (�i <br />Road(s) Being Inspected: +p r Y l z r , ' , <br />Yes No <br />f <br />Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes, which road(s): <br />1>et y <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 />❑ )4 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 />Signature of Inspector: <br />* If any potential subsidence duc'atures" o served that could cause harm <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately. <br />