Minor Structure - Full Report Template.pdf
PDF 1 MB Posted
- Attached to
- RFP 252F-24 Bridge Management System
- Solicitation number
- BD-24-1206-40000-40000-111953
- Issued by
- Suffolk County, Massachusetts
About this file
This document is a Minor Structure Inspection Report template prepared for the Massachusetts Bay Transportation Authority (MBTA), specifically designed for documenting drainage structure inspections. The template provides a comprehensive framework for recording detailed information about a specific drainage structure, including its location, structure number, BIN number, mile point, and inspection date. The report is prepared by Collins Engineers and follows a standardized format with sections for location maps, structure descriptions, condition assessments, sketches, photos, critical findings, and recommendations for repairs and maintenance.
The report template includes multiple appendices and detailed assessment forms for evaluating various structural components such as barrels, headwalls, footings, wingwalls, inlet and outlet conditions, settlement, track surface, channel condition, and embankment. It also incorporates a condition rating guide that ranges from 5 (excellent) to 0 (non-operable), allowing inspectors to systematically document the structural and functional condition of drainage structures. A preliminary repair cost estimate section is included, with notes emphasizing that the costs are rough preliminary estimates based on 2024 pricing and should not be considered formal procurement documents. The template is designed to support the MBTA's Bridge Management Program by providing a standardized method for documenting, assessing, and recommending maintenance and repairs for drainage infrastructure.
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MASSACHUSETTS BAY TRANSPORTATION AUTHORITY
[INSPECTION TYPES] DRAINAGE STRUCTURE INSPECTION
[CARRIED (LINE)] OVER [INTERSECTED]
[TOWN], MA
DRAINAGE STRUCTURE NO. X-00-123
BIN NO. ABC
MILE POINT X.XX
STRUCTURE NO. X-00-123-MBT-TRO
PREPARED BY:
Prime Consultant
685 Canton Street, Suite 102
Norwood, MA 02062
CONTRACT NO. Z94PS30
Task Order No. 2
DATE OF INSPECTION: MONTH XX, 2024
ADD ELEVATION PHOTO OF STRUCTURE
INSERT
PE STAMP,
SIGNATURE,
DATE
MASSACHUSETTS BAY TRANSPORTATION AUTHORITY
[INSPECTION TYPES] DRAINAGE STRUCTURE INSPECTION
[CARRIED (LINE)] OVER [INTERSECTED]
[TOWN], MA
DRAINAGE STRUCTURE NO. X-00-123
BIN NO. ABC
MILE POINT X.XX
STRUCTURE NO. X-00-123-MBT-TRO
PREPARED BY:
Prime Consultant
685 Canton Street, Suite 102
Norwood, MA 02062
CONTRACT NO. Z94PS30
Task Order No. 2
DATE OF INSPECTION: AUGUST 18, 2024
ADD ELEVATION PHOTO OF STRUCTURE
INSERT
PE STAMP,
SIGNATURE,
DATE
CITY, MA XXXXXXXX Line Over XXXXXXX X-XX-XXX (XXX)
RECOMMENDATIONS
FINDINGS (MINOR/MAJOR/CRITICAL) WITH LOCATIONS
No critical findings were found during the inspection.
RECOMMENDATIONS
A. Structural Repair:
Program repairs should be made to the following items as part of the MBTA's Bridge Management Program within the next two (2) years or prior to the next Routine Inspection:
- Item XX.X - XXXXXXX: Recommendation
- Item XX.X - XXXXXXX: Recommendation
- Item XX.X - XXXXXXX: Recommendation
B. Monitoring:
Deficiencies to the following items should be monitored during future inspections:
C. Maintenance:
Program maintenance should be made to the following items as part of the MBTA's Bridge Management Program within the next two (2) years or prior to the next Routine Inspection:
Miscellaneous Items:
Improvements should be made to the following items as part of the MBTA's Bridge Management Program within the next two (2) yeas or prior to the next Routine inspection:
None at this time.
TABLE OF CONTENTS
SECTION Page
LOCATION MAP 1
DESCRIPTION OF DRAINAGE STRUCTURE 2
APPENDIX A – DRAINAGE STRUCTURE INSPECTION REPORT
APPENDIX B – CRITICAL FINDINGS – MBTA NOTIFICATION (if any)
APPENDIX C – PRELIMINARY REPAIR COST ESTIMATE
LOCATION MAP
DESCRIPTION OF DRAINAGE STRUCTURE
Structure ID Number:
Structure Number:
BIN Number:
Mile Point (if any):
Location:
Date of Construction:
Original Design Loading:
Date of Rehabilitation/Reconstruction (If any):
New Design Loading (If any):
Structure Type:
Skew:
Spans:
Width of Structure Deck:
Track Surface:
Curbs:
Sidewalk/Walkway/Median:
Structure Railing:
Protective Screen:
Approach Railing:
Superstructure:
Structure Bearing Type:
Modifications to Original Superstructure:
Utilities:
Substructure:
Modifications to Original Substructure:
APPENDIX A –
DRAINAGE STRUCTURE INSPECTION REPORT
Statement of Concurrence
For the Inspection of Drainage Structure No. , I hereby state that I have reviewed and am in concurrence with but not limited to the following:
Recommendations & Inspection Findings (Minor, Major and Critical)
Location Map
Existing Drawings if any
Photographs
Field Notes on Drainage Structure Deficiencies
Critical Findings - Notification to the MBTA if any
Additional Relevant Drainage Structure Related Documentation if any
Preliminary Repair Cost Estimate (PRCE)
Drainage Structure Video
Consultant P.E. Stamp and Signature Date
PAGE 1 OF
07 - FACILITY CARRIED / LINE MEMORIAL NAME / LOCAL NAME 27 - YR. BUILT 106 - YR. REBUILT VERT. UNDERCLEARANCE
06 - FEATURES INTERSECTED 26 - FUNCTIONAL CLASS MBTA AREA ENGINEER
43 - STRUCTURE TYPE 22 - OWNER 21 - MAINTAINTER TEAM LEADER PROJECT MANAGER NO. TRACKS
107 - DECK TYPE WEATHER TEMP. (AIR) TEAM MEMBERS NO. SPANS
MILE POINT LATITUDE LONGITUDE
INLET - MILE POINT INLET - LATITUDE INLET - LONGITUDE INLET - ELEVATION
OUTLET - MILE POINT OUTLET - LATITUDE OUTLET - LONGITUDE OUTLET - ELEVATION
TYPE OF DRAINAGE STRUCTURE: BARRELS: (FT.)
SIZE / DIAMETER: NUMBER:
DEPTH OF COVER:
(TO THE NEAREST TENTH FOOT)
SEDIMENT DEPTH:
INLET: OUTLET:
G - Good F - Fair P - Poor C - Critical
Structural Condition Rating - The overall rating of the structural elements of the drainage structure. This includes the barrel, headwall, footing, wingwall, settlement, and track surface.
Functional Condition Rating - The overall rating of the structure and its ability to properly function as designed. The rating should be based on the ratings of the Inlet Condition, Outlet Condition, Channel Condition, and embankment condition.
H HIDDEN Structure or element is hidden.
N 15 4
MATERIAL:
INSPECTION DATE
N/E S/WCOATING:
BARREL LENGTH:
RAILROAD/TRANSIT MINOR STRUCTURE INSPECTION
MASSACHUSETTS BAY TRANSPORTATION AUTHORITY
STRUCTURES INSPECTION FIELD REPORT
41 - STATUS
SHAPE:
04 - CITY/TOWN 8 - STRUCTURE NO.
3 2 1 0FUNCTIONAL CONDITION:
CONDITION RATING GUIDE
5 4 3 2N
DEFINTIONS
F 3 ADEQUATE Moderate deterioration. Moderate signs of wear and/or corrosion and some moderate defects and/or visible deterioration, with moderate corrective/capital maintenance needs and minimal functional or level of service impact.
N NOT
APPLICABLE
Not applicable for structure or element.
G 5 EXCELLENT New or like new with no visible defect.
Minor defects. Minor signs of wear and/or corrosion and slight defects and/or visible deterioration, with moderate corrective/capital maintenance needs and minimal functional or level of service impact.
GOOD4G
STRUCTURAL CONDITION:
P 2 MARGINAL Significant deterioration. Major signs of wear and/or corrosion and major defects of primary structural elements and/or visible deterioration, with major corrective/capital maintenance needs and moderate functional or level of service impact. Advanced scour present.
Critical defects. Significant signs of wear and/or corrosion and critical defects and/or visible deterioration, with major impariemtn of asset functionality and level of service provided, substantial asset overhaul required. Unless closely monitored, may be necessary to close the asset until corrective action is taken.
Local failures are possible. Fatigue cracking or shear cracking present and scour seriously affected or has removed substructure support.
POOR1P
C 0 NON-
OPERABLE
(FAILED)
Asset is not in service or non-operable, and/or not capable of or safe for normal operations. Requires major overhaul or disposal/replacement.
PAGE 2 OF
CONDITION ASSESSMENTS
MINOR STRUCTURE/SYSTEM DESCRIPTION:
ACCESS NOTES:
CRITICAL FINDINGS:
RECOMMENDED IMMEDIATE REPAIRS:
OTHER REPAIRS:
RECOMMENDED MAINTENANCE:
INSPECTION DATE
REMARKS
04 - CITY/TOWN 8 - STRUCTURE NO. MILEPOST/ ID NO. 41 - STATUS
PAGE 3 OF
04 - CITY/TOWN 8 - STRUCTURE NO. MILEPOST/ ID NO. 41 - STATUS INSPECTION DATE
BARREL ___
Condition Assessment
Barrel N 5 4 3 2 1 0 H Headwalls N 5 4 3 2 1 0 H
Footing N 5 4 3 2 1 0 H Wingwalls N 5 4 3 2 1 0 H
Inlet Condition N 5 4 3 2 1 0 H Outlet Condition N 5 4 3 2 1 0 H
Settlement N 5 4 3 2 1 0 H Track Surface N 5 4 3 2 1 0 H
Channel Condition N 5 4 3 2 1 0 H Embankment N 5 4 3 2 1 0 H
BARREL ___
Condition Assessment
Barrel N 5 4 3 2 1 0 H Headwalls N 5 4 3 2 1 0 H
Footing N 5 4 3 2 1 0 H Wingwalls N 5 4 3 2 1 0 H
Inlet Condition N 5 4 3 2 1 0 H Outlet Condition N 5 4 3 2 1 0 H
Settlement N 5 4 3 2 1 0 H Track Surface N 5 4 3 2 1 0 H
Channel Condition N 5 4 3 2 1 0 H Embankment N 5 4 3 2 1 0 H
BARREL ___
Condition Assessment
Barrel N 5 4 3 2 1 0 H Headwalls N 5 4 3 2 1 0 H
Footing N 5 4 3 2 1 0 H Wingwalls N 5 4 3 2 1 0 H
Inlet Condition N 5 4 3 2 1 0 H Outlet Condition N 5 4 3 2 1 0 H
Settlement N 5 4 3 2 1 0 H Track Surface N 5 4 3 2 1 0 H
Channel Condition N 5 4 3 2 1 0 H Embankment N 5 4 3 2 1 0 H
Notes:
Notes:
Notes:
CONDITION ASSESSMENTS
PAGE 4 OF
SKETCH / PHOTO LOG
Sketch 1:
Sketch 2:
Photo 3:
Photo 4:
Photo 1:
Photo 2:
Photo 3:
Photo 4:
PAGE 5 OF
SKETCHES
Sketch 1: System Layout
PAGE 5 OF
SKETCHES
Sketch 1: System Layout
PAGE 6 OF
PHOTOS
INSPECTION DATE04 - CITY/TOWN 8 - STRUCTURE NO. MILEPOST/ ID NO. 41 - STATUS
Photo 1:
Photo 2:
PAGE 6 OF
PHOTOS
Photo 1:
Photo 2:
APPENDIX B –
CRITICAL FINDINGS – MBTA NOTIFICATION (IF ANY)
APPENDIX D –
PRELIMINARY REPAIR COST ESTIMATE
Note:
1. The estimated costs are of a rough preliminary nature only for the purpose of giving an understanding to the order of magnitude of the expenses required to correct the deficiencies existing for this structure.
2. This is not intended as a formal estimate of the actual costs to correct the deficiencies present and should not be considered in procuring costs and materials for performing bridge improvements.
3. This Preliminary Repair Cost Estimate was based on 2024 costs and would need adjustments for future dates.
RECOMMENDATIONS
Structural Repair Program repairs should be made to the following items as part of the MBTA's Bridge Management Program within the next two (2) years or prior to the next Routine Inspection:
- Item XX.X - XXXXXX: RECOMMENDATION ($X,XXX)
Monitoring Deficiencies to the following items should be monitored on future inspections:
- Item XX.X - XXXXXX: RECOMMENDATION ($X,XXX)
Maintenance Program maintenance should be made to the following items as part of the MBTA's Bridge Management Program within the next two (2) years or prior to the next Routine Inspection:
- Item XX.X - XXXXXX: RECOMMENDATION ($X,XXX)
Miscellaneous Items Improvements should be made to the following items as part of the MBTA's Bridge Management Program within the next two (2) yeas or prior to the next Routine inspection:
None at this time.
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