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• Forest Service Roads <br />Inspection Form <br />• ° <br />o <br />Date: la -9- I if <br />Time: 3 y c; <br />Name of Inspector: Y. Y � , -„ <br />Current Panel and XC Being Mined: - <br />Road(s) Being Inspected: hr <br />Yes No <br />o <br />Notes: <br />Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes, which road(s): <br />Dr T=a <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 potentially damaging, subsidence induced <br />features on or near the road? If yes, describe: <br />Is mitigation needed? If yes, list suggestions: <br />S <br />teLLeir ( ( 01) <br />Signature of Inspector: <br />* If any potential subsidence educed atures are serve' i • cause harm <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately. <br />