Damage_Survey_Report_FS231-W33-C.pdf
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- Attached to
- Chequamegon-Nicolet National Forest - 2016-1(4) Federal contract opportunity
- Solicitation number
- 693C73-18-B-000021
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Damage Survey Report_FS231-W33-C
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Text version
Sheet No: 1 of 4
DSR No:
Surface Type: Aggregate Thickness: 6"
Surface Type:
Unit Unit Price
Unit Unit Price Lpsm $ Cuyd $ Ton $
Eligible Ineligible
Eligible Ineligible
Disaster No:
Bridge Data:
Type:
ID#:
County: Bayfield / Ashland / Sawyer
Applicant: Chequamegon-Nicolet National Forest
Photograph #:
Road Data: Classification:
Right-of-Way
TOTAL ESTIMATED COST
(Emergency and Permanent Repairs)
Other
DAMAGE SURVEY REPORT
(Title 23, Federal-Aid System/Federal Domain)
Inspection Date: August 22-26, 2016
Location of Damage (Route No., Name of Road and Mile Post) Rte. 231, from MP 0 to MP 3.7 (Beginning at Lat 46°26'39.08", Long 91°21'15.27")
ADT: <200
W33-FS231-C
State:
Wisconsin
Recommended By: (Name and Title)
Date:
*Attach Supplemental Sheets if necessary
Date:
Signature:
Signature:
Signature:
Date:
Submitted By: (Name and Title)
Reviewed By: (Name and Title)
Item Description
MOBILIZATION
AGGREGATE SURFACE COURSE
$0Subtotal Permanent Repairs (continuation sheet)
FEDERAL HIGHWAY ADMINISTRATION, Federal Lands Highway
Proposed: Force Account Contract Total Emergency Repairs
EMBANKMENT CONSTRUCTION
Cost
$0 $0
Cost
$0
$0 $0 $0
COST ESTIMATE for EMERGENCY REPAIRS* Item Description
Traveled Way Width:
Shoulder Width:
Description and Cause of Damage:
Extremely heavy rainfall (8'-11") in less than 24 hours on July 11, 2016, led to extensive flooding and damages to over 1,000 miles of Forest Service Roads, over 3 county area of the Forest.
Scope/Description of Repair:
1. Repair shoulder washouts
COST ESTIMATE for PERMANENT REPAIRS* Quantity
Quantity
$0 $0 $0
$0 $0 $0 $0
$0 $0
$0
$0 $0
$0 $0 $0
Construction Engineering
Proposed: Force Account Contract Total Permanent Repairs Preliminary EngineeringIdentify Betterment, if any, and provide justification*
KATERINA ROMAN GONZALEZ
Digitally signed by KATERINA ROMAN GONZALEZ DN: c=US, o=U.S. Government, ou=DOT FHWASterlingVA, ou=FHWA FHWASterlingVA, cn=KATERINA ROMAN GONZALEZ Date: 2016.10.11 12:51:07 -04'00'
Sheet No: 2 of 4
Disaster No:
Applicant: County: 0 State:
Facility Name: Mile Post:
Picture 1. Water ponding at Site W33, roadway was temporarely.
Picture 2. Left shoulder washout along Rte. 231.
0 0
FEDERAL HIGHWAY ADMINISTRATION, Federal Lands Highway
DAMAGE SURVEY REPORT (Supplemental Sheet) 0
(Title 23, Federal-Aid System/Federal Domain) 0
0 0
Sheet No: 3 of 4
Disaster No:
Applicant: County: 0 State:
Facility Name: Mile Post:0 0
FEDERAL HIGHWAY ADMINISTRATION, Federal Lands Highway
DAMAGE SURVEY REPORT (Supplemental Sheet) 0
(Title 23, Federal-Aid System/Federal Domain) 0
0 0
Rte. 231
Sheet No: 4 of 4
Roadway Roadbed
Reconditioning Embankment Aggregate Surface
Rte. MP. DSR Length (ft) Width (ft) Depth (ft) Area (sqyd) Volume (cuyd) Depth Tons Remark Betterment
231 3.40 W33 50 10 0 0 0 Waterponding/
TEMPORARY REPAIR N
231 3.70 400 0.5 0.5 4 6 8 Shoulder washout (MINOR) N
Totals 0 4 8
#REF!
Drainage
Rte. MP. DSR Existing Size Pipe
Cleaning (ft) Removal of
Pipe Culvert (ft) 24" Pipe Culvert
36" Pipe Culvert
46" Pipe Culvert
Riprap, Class 3 (cuyd)
Totals 0 0 0 0 0 0
FEDERAL HIGHWAY ADMINISTRATION, Federal Lands Highway DAMAGE SURVEY REPORT (Supplemental Sheet)
(Title 23, Federal-Aid System/Federal Domain) Disaster No:
Applicant: County: State: Inspection Date:
Location of Damage (Route No., Name of Road and Mile Post) ADT:
QUANTITY COMPUTATIONS
Remark
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