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Zri,:est Service o c s <br />era ection <br />late: <br />Time: • • 6 <br />Name of Inspector: 6.7� - icc-f -mac:/ <br />Current Panel and XC Being Mined • <br />Road(s) Being Inspected: i'S 77/ <br />Yes No <br />Is the Forest Service road within i e 1: ected ang_° of dray: of <br />subsidence'? If yes, which roe . sj: <br />Are there visib!e surface era :ks on the road? If yes, describe <br />(location, width. length, e:c.): <br />Is there any recent evidence of potential subsidence ind..oed slc)e <br />failure'? If yes, describe: <br />Notes: <br />ingnacure of Inspector: <br />Are there any other pcientially damaging, subsidence induced <br />features on or near the rc i? If yes, descriF <br />Is mitigation needed? If yes. list suggestions: <br />* If any pare_ : a` snhskdence induced fe3tures are observed diat could caase harm <br />to the p):::1_ no`ify Jess_ca Loveland c: _ _ik_e Peacock. imn_edately, <br />