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• Forest Service Roads <br />Inspection Form <br />• o <br />• <br />Date: 5116 ( <br />Time: : I <br />Name of Inspector: (L i 5 ,e 4 wO oC <br />Current Panel and XC Being Mined: £a-,cc <br />Road(s) Being Inspected: Dr,i .1%e r <br />Yes No <br />IX ❑ <br />IA <br />❑ NI <br />Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes, which road(s): <br />Dry Fo. fr- <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 />Are there any other_getantinfiitthmasin& subsidence induced <br />features on or near the road? If yes, describe: <br />see 1 %C1_'.1- <br />Is mitigation needed? If yes, list suggestions: <br />Notes: <br />.r Lotiy* - (014 Cu-vi i a Sip rI ru Ago t' w r C cJ ?,+.- �+-I "0/16 el., J .4' 1:4 e ,• <br />6ry Co ti. fL ;ba j �s•s.Y� spy <br />y6+ Y{or h ofr hit s /`t� �ldrht <br />�t'Bar $ e �r, rs h��Pd "s • J <br />ti:1 sly. 0 51, y} ,, 1l 4 x ca :vim t S . . <br />Signature of Inspector.: Airdatilje <br />* If any potential subside =te Ind ; eatures are observed that could cause harm <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately. <br />