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• <br />Date: / <br />Time: ( 1:oow --- <br />Name of Inspector: a . <br />Current Panel and XC Being Mined: 1.2. XG <br />Road(s) Being Inspected: Ory <br />Yes No <br />❑ ❑ <br />Are there visible surface cracks on the road? If yes, describe <br />(location, width, length, etc.): <br />❑ ❑ Is mitigation needed? If yes, list suggestions: <br />Notes: <br />Forest Service Roads <br />Inspection Form <br />❑ Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes, which road(s): <br />k0r. F-0 r- L-- <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 />✓1/44-C lam` /1 01 <br />Signature of Inspector: <br />* If any potential subsidence induc features s are observed that could cause harm <br />to the public or operations, notify Ryan Sweetwood or Mike Peacock immediately. <br />