Damage_Survey_Report_FS396-W48_W49-D.pdf

PDF 237 KB Posted

Attached to
Chequamegon-Nicolet National Forest - 2016-1(4) Federal contract opportunity
Solicitation number
693C73-18-B-000021
Issued by
Department of Transportation Federal Highway Administration

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Damage Survey Report_FS396-W48 W49-D

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Text version

Sheet No: 1 of

DSR No:

Surface Type: Aggregate Thickness: 6"

Surface Type:

Unit Unit Price

Unit Unit Price Lpsm $ Lpsm $ Lnft $

Cuyd $ Cuyd $ Ton $ Sqyd $ Lnft $ Lnft $ Lnft $

Eligible Ineligible

Eligible Ineligible

2,400

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) Forest Service Route 396 MP 0.0 to 3.0 (SE to NW)

ADT: <200

W48W49-FS396-D

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)

EMBANKMENT CONSTRUCTION

Item Description

MOBILIZATION

REMOVAL OF PIPE CULVERT

$0Subtotal Permanent Repairs (continuation sheet)

800 AGGREGATE SURFACE COURSE

FEDERAL HIGHWAY ADMINISTRATION, Federal Lands Highway

ROADBED RECONDITIONING

Proposed: Force Account Contract Total Emergency Repairs

SOIL EROSION CONTROL

PLACED RIPRAP, METHOD A, CLASS 3

36-INCH EQUIVALENT DIAMETER ARCH OR ELLIPTICAL PIPE CULVERT

CLEANING CULVERTS IN PLACE

Cost

$0 $0

Cost

24-INCH EQUIVALENT DIAMETER ARCH OR ELLIPTICAL PIPE CULVERT

$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 roadway and shoulder washouts

2. Resurface roadway with 3"-6" of Aggregate Surface Course

3. Clean up clogged corrugated metal pipe culverts

4. Replace damaged culverts and place riprap at the outlets

COST ESTIMATE for PERMANENT REPAIRS* Quantity

Quantity

$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*

BENJAMIN D DIXON

Digitally signed by BENJAMIN D DIXON DN: c=US, o=U.S. Government, ou=DOT FHWASterlingVA, ou=FHWA FHWASterlingVA, cn=BENJAMIN D DIXON Date: 2016.10.25 07:44:23 -04'00'

Sheet No: 2 of

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

Sheet No: of

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

Volume Roadbed Reconditioning Embankment Aggregate Surface

Rte. MP. DSR Length Width Depth Area (sqyd) Volume (cuft) Volume (cuyd) Depth Tons Remark 396 0.60 600 10 667 6 225 396 1.20 200 12 5 267 12000 444 6 90 396 2.00 600 5 333 6 113 396 2.30 600 5 333 6 113 396 2.60 600 5 333 6 113 396 2.90 400 10 444 6 150

Totals 2378 12,000 444 803

Culverts

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) Remark 204 7.8 C24 24" 130 130 10

Totals 0 130 0 0 0 10

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