|
1. Date
|
2. Time
|
Status of Bridge or Roadway
3.
Open
4.
Closed
5.
Restricted
|
6. Region
|
7. County
|
8. Route
|
9. Milepost
|
10. Bridge Number (if applicable)
|
11. Location:
|
12. Inspector's Name:
|
13. Remarks
Emergency Bridge Inspection |
Check box that corresponds with any problems below: Note: Only check a box if you are going to close the bridge. |
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. |
|
14.
Bridge Approaches
|
21.
Hinge or Expansion Joints
|
Check for:
General alignment of roadways and rails, and damaged utilities
Raised or lowered approaches
Cracks or buckling in the deck or roadway Raised or protruding joints or utility covers Cracking, crushing, spalling, or misalignment in columns, bent caps, abutments, beams, girders or wing walls Settlement around abutments, columns or walls
Missing bolts or rivets and/or fractured, broken, missing, or damaged anchorage connections. Dislocation or movement of bearings
Changes in water flow or debris accumulations
Loss of soils around footings,walls and roadway embankments due to erosion or scour |
15.
Wing Walls
|
22.
Railings, Parapet, and Curb
|
16.
Bridge Abutments
|
23.
Utilities and Surrounding Areas
|
17.
Bent Caps, and Columns
|
24.
Seismic Restraint Devices
|
18.
Bearings
|
25.
Debris Accumulation in Channel
|
19.
Beams or Girders
|
26.
Undermined Footings
|
20.
Deck (top and underside)
|
|
|
Roadway |
Geo-technical Issues |
27.
Cracking
|
34.
Shoulder settlement
|
28.
Buckling
|
35.
Sags in roadway safety features (guardrail)
|
29.
Heaving or rolling
|
36.
Movement above or below tilted trees
|
30.
Pavement separation
|
37.
Debris on roadway
|
31.
Change in configuration- striping or lane shift
|
38.
Sloughing slopes
|
32.
Change in roadway surface
|
39.
Unstable road blocks above roadway
|
33.
Signs, VMS and sign bridges
|
40.
Sinkhole
|
|
DOT Form 580-020 revised 02/2024
Version 2.0 |