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Forest Service Roads <br />• <br />Inspection Form <br />• <br />• <br />Date: t( ( 2.$1 t t <br />Time: 1- . 00, <br />Name of inspector: i. 5 a,p °-0 <br />Current Panel and XC Being Mined: Kc <br />Road(s) Being Inspected: Dry f . r <br />Yes No <br />p ❑ Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes, which road(s): <br />f f) r �- <br />Is there any recent evidence of potential subsidence induced slope <br />failure? If yes, describe: <br />Notes: <br />❑ Aye there visible surface cracks on the road? If yes, describe <br />location, width, length, etc.): <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 />5 /V 0 w tour 0 — <br />Signature of Inspector: <br />* If any potential subsidence induc - d features are observed that could cause harm <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately. <br />