Element Level Inspection Report SN: District: Spans: Appr. Spans: Skew: ADT: Truck Pct: ADT Un: Maint. Co: Twsp: Status: Facility Carried: Feature Crossed: Municipality: Team/Sub Section: / Insp/Rte: : Bridge Name: Material & Type: Insp. Intervals Fracture Critical: Underwater: Special: Element Level: Routine: 93C– Inspection Date: / / 93C6– Temp. (ºF): Is Delinquent: Reason: 90E Agency Program 90E3 Consultant Program Manager: – – Manager: 90E1 Team Leader: 90E2 Inspector: – – Resources Time to Inspect : Traffic Control: Boat: Waders: Snooper: (H:M): Ladder: Manlift: Bucket Truck: Other: Inspector’s Appraisals Element Element Description Env Quantity Unit CS1 CS2 CS3 CS4 Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Signature Date Inspection Team Leader: / / Consultant Program Manager: / / Agency Program Manager: / / Use Additional as Needed
Element Level Inspection Report SN: District: Spans: Appr. Spans: Skew: ADT: Truck Pct: ADT Un: Maint. Co: Twsp: Status: Facility Carried: Feature Crossed: Municipality: Team/Sub Section: / Insp/Rte: Bridge Name: Material & Type: Insp. Intervals Routine: Fracture Critical: Underwater: Special: Element Level: 93C– Inspection Date: / / 93C6– Temp. (ºF): Is Delinquent: Reason: 90E – Agency Program Manager: 90E3 – Consultant Program Manager: 90E1 – Team Leader: 90E2 – Inspector: Resources Time to Inspect (H:M): : : Traffic Control: Boat: Waders: Snooper: Ladder: Manlift: Bucket Truck: Other: Inspector’s Appraisals Element Element Description Env Quantity Unit CS1 CS2 CS3 CS4 Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Remarks Signature Date Inspection Team Leader: / / Consultant Program Manager: / / Agency Program Manager: / / Use Additional as Needed
BBS%20ELI.docx