Damage_Survey_Report_T1T2-Trail-D.pdf

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

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 30-31, 2016

Location of Damage (Route No., Name of Road and Mile Post) Forest Service Trail NorthEast of Drummond West of Forest Service Route 811

ADT: <200

T1T2-Trail-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)

12,000

900 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 $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: 2016.10.12 10:25:48 -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

Sheet No: 4 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

Volume Roadbed Reconditioning Embankment Aggregate Surface

Rte. MP. DSR Length Width Depth Area (sqyd) Volume (cuft) Volume (cuyd) Depth Tons Remark T1 500 12 667 6 225 T1 5 20 2 200 7 T2 1500 12 6 675 T2 12000 Assume 640 sqft x-section for approximately 500 feet (12 foot traveled way at 20-foot

Totals 667 200 12,007 900

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 T1 24" 20 20 5 T2 Double 36" 140 140 10

Totals 0 160 0 140 0 15