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Forest Sere e ray _ds <br />J ec l'.! on For El'1 <br />Dale: l2 /g/ <br />Time: 9 .'6` C <br />Name of Inspector: L L;Lc-d L 7U( <br />Current Panel and XC Being Mined: `/ - 3 <br />Road(s) Being Inspected: , C;tLA , <br />Yes No <br />Notes: <br />is l forest Service road within the - °c; acted angle of dra' ' of <br />subsidence? 1, yes, which roa<c" s is <br />Are there visible surface crT. ' -.s c.E the road'? If yes, descrir <br />(_: ration_ width, length, etc.): <br />Is there any recent evidence of petsi ial subsidence induced sop <br />tai ure'? If yes, describe: <br />Are the any other potentially damaging, subsider ;e induced <br />features on c- near the road? It Ves, describe: <br />Is mitigation needed? If yes, list suggestions: <br />Signature of Inspectoi:: - <br />- <br />* If ny potential subsidence ' y :raced features ._re cbservecl that could cause harm <br />to the public opet°aticns, t_©tify Robin Schiro -. ?eacock immediately. <br />