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• Forest Service Roads <br />Inspection Form <br />• <br />Date: 0S I �1 <br />Time: 3:30 <br />Name of Inspector: S ®SA . 5 • R y 014 S <br />Current Panel and XC Being Mined: F Z )C c / Z <br />Road(s) Being Inspected: Orr 5s k <br />Yes No <br />4 ❑ Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes, which road(s): <br />bf o?/ <br />Are there visible surface cracks on the road? If yes, describe <br />(location, width, length, etc.): <br />El a <br />❑ ( <br />Is there any recent evidence of potential subsidence induced slope <br />failure? If yes, describe: <br />❑ 5 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 />Signature of Inspector�� <br />* If any potential subs' ence induced features are observedlat could caus <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock= iately. <br />