Damage_Survey_Report_FS387-W40-B.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_FS387-W40-B
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Text version
Sheet No: 1 of 5
DSR No:
Disaster No:
County: Latitude:
State: Longitude:
Facility Number: Mile Post:
Maint. Level:
Type: Traveled Way Width: 18 Surface Type: Gravel Thickness: 6" ADT:
ID#: Shoulder Width: 2 Surface Type: N/A Thickness: N/A Inspection Date:
Unit Unit Price
Proposed:
Unit Unit Price Lpsm Lpsm Lnft Ton Sqyd
Proposed:
20%
10%
100.00%
Eligible Ineligible
Eligible Ineligible
Construction Engineering (percent of permanent repair construction)
ERFO share of Permanent Repairs (Sliding Scale) * TOTAL EMERGENCY REPAIRS and ERFO SHARE of PERMANENT
REPAIRS
$0 $0
Recommended By: FLH ERFO Coordinator Signature: Date:
$0 $0
Total Estimated Permanent Repairs - Construction Identify Betterment and provide supporting documentation and economic justification on attached sheets.
* Tribal transportation facilities and federal lands transportation facilities are at 100%. Other federally owned roads are at the sliding scale. See attached table.
Site: 00 00' 00" N
Signature: Date:
Reviewed By: (Name and Title) Signature: Date:
Submitted By: (Name and Title)
(amount from continuation sheet) $0
$0 $0
$0
Preliminary Engineering (percent of permanent repair construction)
$0
$0 $0
ROADBED RECONDITIONING
$0
EMBANKMENT CONSTRUCTION
AGGREGATE SURFACE COURSE
MOBILIZATION
SOIL EROSION CONTROL
$0
COST ESTIMATE for PERMANENT REPAIRS Quantity Item Description Cost
$0
$0
Total Estimated Emergency Repairs
$0 $0
$0 $0
Facility Name:
Chequamegon Nicolet National Forest
Forest Service
FR-387
$0
Description and Cause of Damage:
Severe storm on July 11, 2016 with heavy rains receiving about 8- 12 inches of precipitation during a 24-hour period, resulting in flash flooding and causing damages to the roads, bridges, and other road structures in the Forest Service.
Scope/Description of Repair:
1. Repair roadway and shoulder washouts
2. Resurface roadway with Aggregate Surface Course
FR-387
FEDERAL HIGHWAY ADMINISTRATION, Federal Lands Highway
DAMAGE SURVEY REPORT W40-FS387-B
(Title 23, Federal-Aid System/Federal Domain)
COST ESTIMATE for EMERGENCY REPAIRS Quantity Item Description Cost
<200
8/26/2016
Classification:Road Data:Bridge Data:
Site: 00 00' 00" W
Ashland County
Wisconsin
Applicant:
Agency:
WI2016-1-FS
Force Account Contract
Force Account Contract
NTTFI/NFLTFI
WENDY HICIANO
Digitally signed by WENDY HICIANO DN: c=US, o=U.S. Government, ou=DOT FHWASanJuanPR, ou=FHWA FHWASanJuanPR, cn=WENDY HICIANO Date: 2016.10.28 14:33:00 -04'00'
Sheet No: 2 of 5
Disaster No:
Applicant: County: Ashland County State:
Facility Name: Mile Post:
Figure 1: Washout shoulders
Figure 2: Ditch reconditioning needed
Wisconsin
FEDERAL HIGHWAY ADMINISTRATION, Federal Lands Highway
DAMAGE SURVEY REPORT (Supplemental Sheet) W40-FS387-B
(Title 23, Federal-Aid System/Federal Domain) WI2016-1-FS
FR-387
Chequamegon Nicolet National Forest
Sheet No: 3 of 5
Disaster No:
Applicant: County: Ashland County State:
Facility Name: Mile Post:
Figure 3: Washout road section temporarily repaired
Figure 4: Washout shoulder section
FR-387 0
FEDERAL HIGHWAY ADMINISTRATION, Federal Lands Highway
DAMAGE SURVEY REPORT (Supplemental Sheet) W40-FS387-B
(Title 23, Federal-Aid System/Federal Domain) WI2016-1-FS
National Forest Wisconsin
Sheet No: 4 of 5
Disaster No:
Applica nt: County: Ashland County State:
Facility Name: Mile Post:
Permanent Repair
VOLUME
Roadbed
Reconditioning Embankment Aggregate Surface Rte. Latitude Longitud e Length (ft) Width (ft) Depth (ft) Area (sqyd) Volume (cuft) Volume (cuyd) Depth (in) Tons Remark
FR-387 46.2989 90.89082 100 7 0 78 0 0 6 26 Erosion and ponded water RT side FR-388 46.2989 90.89082 175 6 2 117 2100 78 6 39 RT side
FR-389 46.2971 90.88586 175 5.5 2 107 1925 71 6 36
FR-390 46.295 90.88457 500 5.5 3 306 8250 306 6 103 RT side FR-391 46.295 90.88457 250 3 1 83 750 28 6 28 LT Side FR-392 46.2853 90.87447 75 3 0 25 0 0 3 4 RT side FR-393 46.2843 90.87396 200 18 0 400 0 0 6 135 Road Resurface FR-394 46.283 90.87336 300 2.5 0.75 83 562.5 21 6 28 RT side FR-395 46.2798 90.87171 300 3 1.5 100 1350 50 6 34 RT side FR-396 46.2672 90.87147 250 18 0 500 0 0 3 84 Road Resurface FR-397 46.2603 90.87053 100 25 0 278 0 0 3 47 Road Resurface (Minor)
Totals 2076 553 565
*Quantities are round up or down to the nearest 5
FR-387 0
FEDERAL HIGHWAY ADMINISTRATION, Federal Lands Highway DAMAGE SURVEY REPORT (Supplemental Sheet) W-40-FS387-B
(Title 23, Federal-Aid System/Federal Domain) WI2016-1-FS
Chequamegon Nicolet National Forest Wisconsin
Sheet No: 5 of 5
Disaster No:
Applicant: County: Ashland County State:
Facility Name: Mile Post: 0
FEDERAL HIGHWAY ADMINISTRATION, Federal Lands Highway
DAMAGE SURVEY REPORT (Supplemental Sheet) W40-FS387-B
(Title 23, Federal-Aid System/Federal Domain) WI2016-1-FS
Wisconsin
FR-387
National Forest
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