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Dale: /0' C 2 <br />Time: /7 :.-6 7 7 --;"6 <br />Name of Inspector: <br />Current Panel and XC Being Mined: /I:- `> -7 <br />Roads) Being Inspected: <br />Yes No <br />Is Ale Forest Seivi._.e road within t e } :, c fcted angle of dra' ' of <br />subsidence? If yes, which raacls'r: <br />Are t[ - _ire visible surface eri-: ,s ( t the road? If yes, descril .' <br />-ration, width. length, etc.): <br />Notes: <br />F, :rest Sery ce Ron s <br />}1 js'ct_an Form <br />Is there any recent evidence of poten ial subsidence induced s :ol. <br />failure? if yes, describe: <br />Are there any other potentially damaging, subsider_ -;e induced <br />features on c ,' : ear the i oad'? If yes, describe: <br />Is mitigation needed? If yes, list suggestions: <br />Signature of inspecto <br />v If any potential subsidenc induced features are observed that could cause harm <br />to the public or operations, =otify Robin Schiro or Mike Peacock immediately. <br />