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Forest Service Roads <br />Inspection Form <br />Date: U `7. / 9 // <br />Time: � p ,- —_ _ <br />Name of Inspector: j�" I -, i J <br />Current Panel and XC Being Mined: 6 1.---- <br />_.r <br />Road(s) Being Inspected: - 7 / <br />Yes No <br />,, ❑ Is the Forest Service road within the projected angle of draw of <br />subsidence? Ifyes, which road(s): <br />O 0 Are there visible surface cracks on the road? If yes, describe <br />(location, width, length, etc.): <br />;\ <br />❑ ❑ <br />D D <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 />N A <br />❑ ❑ Is mitigation needed? If yes, List suggestions: <br />R c ) QcL V o� <br />Signature of Inspector: <br />* If any potential subsidence induce attires are observed that could cause harm <br />to the public or operations, notify Robin Schiro or Mike Peacock immediately. <br />