ADA/PROWAG Inspection Summary Job/Permit No: Date: Route: Inspector: Limits: Resident Engineer Checked: Municipality: County: FOR ADA COORDINATOR USE ONLY Date Uploaded into ADA Inventory: Uploaded By: List of facilities altered by construction improvement including curb ramps, crosswalks (marked/unmarked), Traffic Signals (APS), and/or sidewalks. For those facilities that are not compliant, attach ADA/PROWAG Inspection Sheet (D1 PD0031), ADA Construction Concurrence (BDE 5801), and supporting documentation justifying non-compliance. These must be presented by the Bureau in charge of the alteration at the next monthly FHWA/BDE Coordination Meeting. Submit the ADA/PROWAG Inspection Summary form to the D1 ADA Coordinator. Corner or Cross Street Crossing Leg ADA/PROAG **FOR NON-COMPLIANT FACILITIES** Marked Route/Street (for SW, include Facility Type Direction Compliance Inspector must complete the following distance to nearest (NB/SB/EB/WB) cross street) Leg –N/S/E/W Curb Ramp BDE 5801 Completed w/ Documentation Crosswalk Compliant Traffic Signal Date Presented to FHWA/BDE: Sidewalk Curb Ramp BDE 5801 Completed w/ Documentation Crosswalk Compliant Traffic Signal Date Presented to F HWA/BDE: Sidewalk Curb Ramp BDE 5801 Completed w/ Documentation Crosswalk Compliant Traffic Signal Date Presented to FHWA/BDE: Sidewalk Curb Ramp BDE 5801 Completed w/ Documentation Crosswalk Compliant Traffic Signal Date Presented to FHWA/BDE: Sidewalk Curb Ramp BDE 5801 Completed w/ Documentation Crosswalk Compliant Traffic Signal Date Presented to FHWA/BDE: Sidewalk
ADA/PROWAG Inspection Summary Job/Permit No: Date: Route: Inspector: Limits: Resident Engineer Checked: Municipality: County: FOR ADA COORDINATOR USE ONLY Date Uploaded into ADA Inventory: Uploaded By: List of facilities altered by construction improvement including curb ramps, crosswalks (marked/unmarked), Traffic Signals (APS), and/or sidewalks. For those facilities that are not compliant, attach ADA/PROWAG Inspection Sheet (D1 PD0031), ADA Construction Concurrence (BDE 5801), and supporting documentation justifying non-compliance. These must be presented by the Bureau in charge of the alteration at the next monthly FHWA/BDE Coordination Meeting. Submit the ADA/PROWAG Inspection Summary form to the D1 ADA Coordinator. Marked Route/Street Cross Street (for SW, include distance to nearest cross street) Corner or Leg Leg –N/S/E/W Crossing Direction (NB/SB/EB/WB) Facility Type ADA/PROAG Compliance **FOR NON-COMPLIANT FACILITIES** Inspector must complete the following Curb Ramp Crosswalk Traffic Signal Sidewalk Compliant BDE 5801 Completed w/ Documentation Date Presented to FHWA/BDE: Curb Ramp Crosswalk Traffic Signal Sidewalk Compliant BDE 5801 Completed w/ Documentation Date Presented to F HWA/BDE: Curb Ramp Crosswalk Traffic Signal Sidewalk Compliant BDE 5801 Completed w/ Documentation Date Presented to FHWA/BDE: Curb Ramp Crosswalk Traffic Signal Sidewalk Compliant BDE 5801 Completed w/ Documentation Date Presented to FHWA/BDE: Curb Ramp Crosswalk Traffic Signal Sidewalk Compliant BDE 5801 Completed w/ Documentation Date Presented to FHWA/BDE:
D1%20PD0039.docx