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Forest Service Roads <br />• Inspection Form <br />• <br />Date: 66/ <br />Time: :Gog6\ <br />Name of Inspector: Cv E ^ t <br />Current Panel and XC Being Mined: FZ <br />Road(s) Being inspected: mvill per <br />Yes No <br />❑ <br />0 )4 <br />• <br />Qi <br />Is the Forest. Service road within the projected angle of draw of <br />subsidence? If yes, which road(s): <br />❑ y Are there visible surface cracks on the road? If yes, describe <br />(location, width, length, etc.): <br />)8 0 <br />Notes: <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 />t-iktc 11 5 a 4) aniA l0 MD of ‘90 41 n1A rIA <br />❑ I mitigation. needed? If yes, list . suggestions: <br />rdol <br />Signature of Inspector: <br />* If any potential subsi a ence induced features are observed that could cause harm <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately. <br />