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Forest Service Roads <br />Inspection Form <br />Date: /W?1- -` Iff <br />Time: /(,) — qca <br />Name of Inspector: e /a oc� <br />Current Panel and XC Being Mined: <br />Road Being Inspected: 0 <br />Yes No <br />[� ❑ Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes, which road(s): <br />E ❑ Are there visible surface cracks on the road' If yes, describe <br />(location, width, length, etc.): <br />11 El <br />❑ D <br />El El <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 />Is mitigation needed? If yes, list suggestions: <br />/L4r C�r�s /cC c` <br />Signature of Inspector:° <br />* If any potential subsidenc nduced features are observed that could cause harm <br />to the public or operations, notify Robin Schiro or Mike Peacock immediately. <br />