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Forest Service Roads <br />Inspection. Form <br />• <br />Date: Dc, <br />Time: 1 -1 <br />Name of Inspector: <br />Current Panel and XC Being Mined: f i X t 11. <br />Road(s) Being Inspected: v ��, <br />Yes No :J <br />Pt 0 <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 />ig Are there any other potentially damaging, subsidence induced <br />features on or near the road? If yes, describe: <br />0 Is mitigation needed? If yes, list suggestions: <br />Notes: <br />Signature of Inspector: <br />* If any potential sub , %ence induced eatures are observed that could cause harm <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately. <br />