Routine Condition Inspection Form BRIDGES (EXCEPTING LOG OR TIMBER STRINGER STRUCTURES)

(First Span, for additional spans use form FS1337B-2)

GENERAL INFORMATION

Page 1 of 3

LEFT/RIGHT APPROACHES (as seen facing downstream) E = excellent; G = good; F = fair; P = poor; N/A = not applicable; U = unrated

Alignment UPFGE

Item Present Condition Comments (comment mandatory if condition 'Poor' or 'Unrated' is selected)

0 1 2Bridge Ahead Signs Missing

Yes NoBrushing Required

Delineator Missing Left

Delineator Missing Right

0 1 2

0 1 2

Posted Load Rating (tonnes)

Log/Timber Cribs

Comments (comment mandatory if condition 'Poor' or 'Unrated' is selected)Present ConditionItem

LEFT/RIGHT ABUTMENTS (as seen facing downstream)

Fender Condition G F P None UE

E G F P URoad Surface

Tie-Backs

Bin Wall

E G F P N/A UConcrete (cast in place, lock blocks, precast)

E G F P UCaps or Sills

E G F P N/A UPiles or Posts (piles numbered from upstream side)

E G F P UBallast Wall

E G F P N/A UWing Wall

E G F P UN/ABracing

E G F P N/A UHardware

E G F P UFill

E G F P N/A URiprap

FS1337B-1 WV 1.1 Aug. 9, 2013

UN/APFGE

UPFGE

Bearings

Corrosion Protection

UPFGE

UN/APFGE

UN/APFGE

Notes:

Link to CBR Definitions

OR UTM Zone

Longitude (ddd mm ss.s)

UTM Easting

Latitude (dd mm ss.s)

UTM Northing

*Crossing Name

*km (from POC)

*Project File ID *Branch

User km

*District

Permanent Bridge Temporary Bridge*Type/Class:*Structure #:*Site #:

*FSR Name

Page 2 of 3Span 1 of

DECK

SUPERSTRUCTURE

Comments (comment mandatory if condition 'Poor" or 'Unrated" is selected)Present ConditionItem

(number consecutively starting from the left abutment); Use "Additional Spans" sheet for Multiple Spans.

Running Surface (N/A if running surface is gravel or timber planks)

Running Planks

Sub-deck

Ties

Nails

Deck to Girder Bolts

E G F P N/A UConcrete Deck

E G F P N/A UGrout Pockets

E G F P UN/ADeck Joints

Est. Present Water Level Depth (m) Est. Present Water Level Width (m) *Est. High Water Level Clearance (m)

Yes No Yes No Yes No Yes No

High Water? Scour? Ice? Debris? Aggradation?

Yes No

UPFGE

UN/APFGE

UPFGE

E G F P N/A USteel Deck Plate

E G F P N/A UGravel Surface

E G F P UCurb Rails/Blocks/Posts

E G F P N/A UHandrails/Walkouts

E G F P N/A UHardware

E G F P UOverall Deck Condition

UPFGEGirders

Comments (comment mandatory if condition 'Poor' or 'Unrated' is selected)Present ConditionItem

UPFGEDiaphragms

UN/APFGEBracing

UN/APFGEUnder-trussing

UN/APFGEHardware

UN/APFGEWelded / Grouted Shear Connectors

STREAM CHANNEL

STREAM HAZARDS

Comments:

UPFGE

UPFGE

E UN/APFG

FS1337B-1 WV 1.1 Aug 9, 2013

Gravel Deck Depth(in metres)

Page 3 of 3

FS1337B-1 WV 1.1 Aug. 9, 2013

2

1

MonitorItem #

*Monitor Description

PHOTO LOG

Description (*if "other" selected)

INSPECTOR TO COMPLETE THIS SECTION

Inspector's Comments:

PROFESSIONAL ENGINEER TO COMPLETE THIS SECTION

*Current Load Rating (GVW (tonnes):

Reviewed by - PEng's NameDate Reviewed (yyyy/mm/dd)

P.Eng. Reviewer's Comments:

*Photo View *Photo #

Description (*if "other" selected)*Photo View

*Monitoring Frequency

3

1

3

5

9

7

2

4

6

8

10

Notes: Site location and inventory forms FS1342 "Site Inventory Data Form" and FS 1343 "Structure Inventory Data Form: Bridges" may be required to be completed in conjunction with an inspection form. An asterisk (*) denotes mandatory information for CBR - may not be readily available or known in the field.

*Photo #

3 LMH

LMH2

1 LMH

Repair Item #

*Priority (H = High, M = Medium, L = Low)

*Estimate ($) *Repair Description

REPAIRS

MONITORING ITEM

Recommended Not Required

Recommended Not Required

Reviewed by - PEng's Signature

*Inspection Company Name

Light Vehicle Traffic (year)

Full Log Haul Traffic (year)

P Eng Inspection Required?

* Date of Inspection (yyyy/mm/dd) *Inspector's Name

Inspector's Estimate of Replacement Dates (Year) for: (PEng. to review and evaluate inspector's estimate and to update in CBR as necessary)

Inspector's Signature

As-Built Drawings Checked?

No NoYesYes

*Date of Next Planned Inspection (yyyy/mm/dd):