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• Forest Service Roads <br />Inspection Form <br />• <br />Date: V 114 <br />Time: 3: oft <br />Name of Inspector: <br />Current I?anel and XC Being Mined: 2-.2- x3d <br />Road(s) Being Inspected: Dr-1 Fa,r1G <br />Yes No <br />i2V 0 <br />Notes: <br />Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes, which road(s): <br />p FOY- <br />0 Are there visible surface cracks on the road? If yes, describe <br />(location, width, length, etc.): <br />• 0 0 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 />El Is mitigation needed? If yes, list suggestions: <br />SAJ Q tn/ C'O V E IZ- ~ L nG„c SS 1 ,��.� <br />Signature of Inspector: <br />* If any potential subsidence induce atur ... observed that -co' a cause harm <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately, <br />