Damage_Survey_Report_FS392-W44-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_FS392-W44-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 $ Ton $
Eligible Ineligible
Eligible Ineligible
Construction Engineering
Proposed: Force Account Contract Total Permanent Repairs Preliminary EngineeringIdentify Betterment, if any, and provide justification*
$0 $0 $0
$0 $0 $0 $0
$0 $0
$0
$0 $0
COST ESTIMATE for PERMANENT REPAIRS* Quantity
Quantity
$0 $0 $0
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. Resurface shoulder washouts with 3"-6" of Aggregate Surface Course
$0
$0 $0 $0
COST ESTIMATE for EMERGENCY REPAIRS* Item Description Cost
$0 $0
Cost
FEDERAL HIGHWAY ADMINISTRATION, Federal Lands Highway
Proposed: Force Account Contract Total Emergency Repairs
AGGREGATE SURFACE COURSE
$0Subtotal Permanent Repairs (continuation sheet)
Submitted By: (Name and Title)
Reviewed By: (Name and Title)
Item Description
MOBILIZATION
W44-FS392-C
State:
Wisconsin
Recommended By: (Name and Title)
Date:
*Attach Supplemental Sheets if necessary
Date:
Signature:
Signature:
Signature:
Date:
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. 392, Jahn's/Raynard Lake Rd from MP 0 to MP 6.2 (Beginning at Lat 46°23'29.02", Long 91°19'7.72")
ADT: <200
$0
Disaster No:
Bridge Data:
Type:
ID#:
County: Bayfield / Ashland / Sawyer
Applicant: Chequamegon-Nicolet National Forest
Photograph #:
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 12:56:57 -04'00'
Sheet No: 2 of 4
Disaster No:
Applicant: County: 0 State:
Facility Name: Mile Post:
Picture 1. Shoulder washout along Rte. 392
Picture 2. Shoulder washout along Rte. 392
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. 392
Sheet No: 4 of 4
Roadway
Embankment Aggregate
Surface Rte. MP. DSR Length Width Depth Area (sqyd) Volume (cuyd) Depth Tons Remark Betterment 392 2.90 500 5 3 47 Shoulder washout LT (MINOR) 392 2.90 500 5 3 47 Shoulder washout RT (MINOR) 392 3.30 W44 800 5 6 150 Shoulder washout LT (MINOR) 392 4.00 800 5 3 75 Shoulder washout LT (MINOR)
Totals 0 0 319
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
Remark
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
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