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Yes No <br />Forest Service Roads <br />Inspection Form <br />Date: (/Z <br />Time: c r-) <br />Name of Inspector: ;' �; <br />Current Panel and XC Being Mined: <br />Road(s) Being Inspected: ,.- ,:fs ,:f_ i � <br />❑ Is the Forest Service road within the projected angle of draw of <br />subsidence? If yes. which road(s): <br />f ) _ - r'11 <br />❑ ❑ <br />Notes: <br />Are there visible surface cracks on the road? If yes, describe <br />(location. width, length, etc.): <br />Is there any recent evidence of potential subsidence induced slope <br />failure? If yes, describe: <br />N A <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 />Signature of Inspector: - * <br />* If any potential subsidence induced - atures are observed that could cause harm <br />to the public or operations, notify Robin Schiro or Mike Peacock immediately. <br />