Washington State
Department of Transportation |
Bridge Damage Report Form
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|
1. Date
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2. Time
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Status
3.
Open
4.
Restricted
5.
Closed
6.
Collapsed
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7. Region
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8. County
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9. Route
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10. Milepost
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11. Bridge Number
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| 12. Location:
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13. Inspector's Name
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14. Remarks
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| Emergency Bridge Inspection |
Check boxes that correspond with any problems below:
Note:Only check a box if you are going to close the bridge. |
Items |
Check for |
15.
Bridge Approaches
|
Raised or lowered, cracks, or buckling |
16.
Wing Walls
|
Excessive cracks or spalling |
17.
Bridge Abutments
|
Excessive cracks, spalling or movement at the ground level |
18.
Bent Caps, and Columns
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Excessive cracks, spalling, bearing movement, missing girder stops, out of plum, or movement at the ground level with disturbed soil |
19.
Bearings
|
Missing, unseated with less than 6” bearing, misalignment, sheared, or bent bolts |
20.
Beams or Girders
|
Misalignment, distortion, excessive cracking, spalling, or missing bolts or rivets |
21.
Bridge Deck (top and underside)
|
Excessive cracks, spalling, shifting, raised or depressed areas |
| 22.
Hinge or Expansion Joints
|
Misalignment, excessive cracks, spalling, torn or protruding materials |
| 23.
Hand Rail, Parapet, and Curb
|
Misalignment, distortion, separation, excessive cracking or spalling |
| 24.
Utilities and Surrounding Areas
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Disturbed soil, soil liquefaction, damaged utilities, sand blows, and surrounding structure damage. |
| 25.
Seismic Restraint Devices
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Bent, fractured, broken, missing, damaged anchorage connections |
How to tag a bridge properly:
If Bridge is SAFE to stay OPEN, apply GREEN tape with the date, time, and inspector's initials to right hand side of the bridge on the approaching corner.
If Bridge is UNSAFE and to be CLOSED, apply RED tape with date. time, and inspector's initials to right hand side of the bridge on the approaching corner. |
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