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Da'e' /i / - Titre: <br />Name of Inspector: <br />Current Panel and XC Being Mined: / 7 <br />Road(s) Being Inspected: <br />J <br />Notes: <br />[ <br />ii; or°est Roads <br />.ect cin <br />9 <br />Yes No <br />Is =}-e Forest ; erv-x road within the F`-c_ eted an of dra"�l of <br />subsidence'? If yes. which _road "s): <br />Are ti - _ n-e visible surface crac_es c h the road? if yes, descriL <br />(« ration., width, length, etc.): <br />Es there any recent evidence of potet ial subsidence induced sole <br />lai:ure? if yes, describe: <br />Are the - . - e any other potentially darriagir J., subsides .x induced <br />features 00 e_' near the road? If yes describe: <br />Is mitigation needed? if yes, list suggestions: <br />4// d',/Gt1 ✓ /7G�� � c4�c =t_,L <br />Signature of Inspec ter: ' f �. , / <br />If my potential subside ce induced features are observed that could cause harm <br />to the public or operations, notify Robin Schiro or Mike ?ecock immediately. <br />