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SITE INSPECTION FORM

********** G E N E R A L BRIDGE I N F O R M A T I O N **********

Location
Bridge ID Bridge Name
Region Engineering District

********** G E N E R A L BRIDGE D A T A **********

Height Clearance Maximum


Posted Load Limit Year of Construction
Over Under Bridge Height
(Ton) (m) (m) (m) (yyyy)

********** B R I D G E G E O M E T R Y **********

Overall Width
Overall Number Number Width of Width of
Width of Sidewalk
Length of Spans of Lanes Carriageway Shoulder(s)
N.B S.B N.B S.B N.B S.B
(m) (-) (-) (m) (m) (m) (m) (m) (m)

Traffic Direction □ One Way □ Two Way

Type of Bridge : □ RCDG □ PSCG □ Bailey □ Other :

Public Utilities Carried by the Bridge :


Type of Utility Description of the Utility

Is lighting provided on the Bridge : □ Yes □ No

Interval of Light Poles : ________ (m)

Comments : (Bridge inspector comments for any unusual features)

Foresight Development and Surveying Company 1


SITE INSPECTION FORM
********** G E N E R A L BRIDGE I N F O R M A T I O N **********

Location
Bridge ID Bridge Name
Region Engineering District

Inspected by : Date of Inspection : _________________


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********** S P A N D A T A **********

Span Length of SpanSkew Angle


No. of Main Members
Number (m) (degree)
□ 1 □ 2 □ 3 □ 4 □ 5 □ 6 □ 7 □ 8

Main Member Type


□ RCDG □ PSCG □ DPG □ SLAB □ VOIDED SLAB □ TROUGH TRUSS □ DECK TRUSS □ BA

Continuity
i - end j - end
□ Fixed □ Continuous □ Moveable □ Simple
□ Fixed □ Continuous □ Moveable □ Simple

Secondary Member Type


Secondary Member Material Other Member Type

Deck Material : ______________________________

Railing Type : ______________________________

Comments : (Bridge inspector comments for any unusual features)

Inspected by : Date of Inspection : _________________


1.

Foresight Development and Surveying Company 2


SITE INSPECTION FORM
********** G E N E R A L BRIDGE I N F O R M A T I O N **********

Location
Bridge ID Bridge Name
Region Engineering District

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********** B R I D G E PIER D A T A **********

Number Type Material Height Height Case Pier Foundation Type

Bearing Type at Low and High Chainage


□ Elastomeric Bearing Pad □ Pot Bearing □ Rocker Bearing □ Steel Plate □ PTFE Coated Pla

Lateral Restraint Type


□ Concrete Shear Key □ Bolts □ Other : ______________________________

Longitudinal Restraint Type


□ Longitudinal Cable Restrainers □ Bolts □ Other : ______________________________

Expansion Joint Type : ______________________________

Scour Protection : ______________________________

Comments : (Bridge inspector comments for any unusual features)

Foresight Development and Surveying Company 3


SITE INSPECTION FORM
********** G E N E R A L BRIDGE I N F O R M A T I O N **********

Location
Bridge ID Bridge Name
Region Engineering District

Inspected by : Date of Inspection : _________________


1.
2.
3.
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5.

********** A B U T M E N T D A T A **********

Number Type Material Height Height Case Pier Foundation Type

Bearing Type at Low and High Chainage


□ Elastomeric Bearing Pad □ Pot Bearing □ Rocker Bearing □ Steel Plate □ PTFE Coated Pla

Lateral Restraint Type


□ Concrete Shear Key □ Bolts □ Other : ______________________________

Longitudinal Restraint Type


□ Longitudinal Cable Restrainers □ Bolts □ Other : ______________________________

Expansion Joint Type : ______________________________

Scour Protection : ______________________________

********** W I N G W A L L / SIDEWALL D A T A **********

Foresight Development and Surveying Company 4


SITE INSPECTION FORM
********** G E N E R A L BRIDGE I N F O R M A T I O N **********

Location
Bridge ID Bridge Name
Region Engineering District

Type
□ Solid Wall □ Reinforced Earth □ Protected Slope □ Other : ______________________________

Material Length Foundation Type


□ Attached to Abutment □ Spread Footing □ Pile □ Other : _________________

Comments : (Bridge inspector comments for any unusual features)

Inspected by : Date of Inspection : _________________


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5.

Type D1 D2 D3 D4 D5 D6 B1 B2 B3 B4 B5 B6
I 28 4 0 3 5 5 12 16 6 3 0 5
II 36 6 0 3 6 6 12 18 6 3 0 6
III 45 7 0 4.5 7.5 7 16 22 7 4.5 0 7.5
IV 54 8 0 6 9 8 20 26 8 6 0 9
V 63 5 3 4 10 8 42 28 8 4 13 10
VI 72 5 3 4 10 8 42 28 8 4 13 10

Foresight Development and Surveying Company 5


SITE INSPECTION FORM
********** G E N E R A L BRIDGE I N F O R M A T I O N **********

Location
Bridge ID Bridge Name
Region Engineering District

Type D1 D2 D3 D4 D5 D6 B1 B2 B3 B4 B5 B6
I 711.2 101.6 0 76.2 127 127 304.8 406.4 152.4 76.2 0 127
II 914.4 152.4 0 76.2 152.4 152.4 304.8 457.2 152.4 76.2 0 152.4
III 1143 177.8 0 114.3 190.5 177.8 406.4 558.8 177.8 114.3 0 190.5
IV 1372 203.2 0 152.4 228.6 203.2 508 660.4 203.2 152.4 0 228.6
V 1600 127 76.2 101.6 254 203.2 1067 711.2 203.2 101.6 330.2 254
VI 1829 127 76.2 101.6 254 203.2 1067 711.2 203.2 101.6 330.2 254

Foresight Development and Surveying Company 6


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ing District

of Construction

(yyyy)

of Sidewalk
S.B
(m)

Foresight Development and Surveying Company 7


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ing District

_______________

6 □ 7 □ 8

DECK TRUSS □ BAILEY

eable □ Simple

pe

_______________

Foresight Development and Surveying Company 8


****

ing District

dation Type

□ PTFE Coated Plate

_______

_____________

Foresight Development and Surveying Company 9


****

ing District

_______________

dation Type

□ PTFE Coated Plate

_______

_____________

Foresight Development and Surveying Company 10


****

ing District

_____________________

er : _________________

_______________

Foresight Development and Surveying Company 11


SITE INSPECTION FORM
********** G E N E R A L BRIDGE I N F O R M A T I O N **********

Location
Bridge ID Bridge Name
Region Engineering District

Orientation of the Bridge Alignment with the Flow Skew Angle (degree)
□ Skewed □ Normal □ Other : ____________________

Navigation Access for Vessels : □ Yes □ No

Survey of Water Level :


Year of Water Levels
Respondent's Name Age
Residence O.W.L O.F.W.L O.M.F.L

Presence of Water : □ Yes □ No

Water Flow : □ Laminar □ Turbulent □ Estuary □ Other : _______________

Type of Flowing Debris : □ Logs □ Leaves □ Domestic Wastes Other : _______

Observed Intensity of Debris : □ Light □ Moderate □ Heavy

Upstream Description
Vegetation : □ Yes □ No

Downstream Description
Vegetation : □ Yes □ No

Presence of Scouring
Abutment A Abutment B Pier 1 Pier 2 Pier 3
□ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Sign of Siltation
Abutment A Abutment B Pier 1 Pier 2 Pier 3
□ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Presence of Slope Protections


Abutment A Abutment B Pier 1 Pier 2 Pier 3
□ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Comments : (Bridge inspector comments for any unusual features)

Foresight Development and Surveying Company 12


SITE INSPECTION FORM
********** G E N E R A L BRIDGE I N F O R M A T I O N **********

Location
Bridge ID Bridge Name
Region Engineering District

Inspected by : Date of Inspection : _________________


1.
2.
3.
4.
5.

Foresight Development and Surveying Company 13


****

ing District

gle (degree)

O.M.F.L

Other : ___________________

es Other : _____________

□ Heavy

Pier 3
es □ No

Pier 3
es □ No

Pier 3
es □ No

Foresight Development and Surveying Company 14


****

ing District

_______________

Foresight Development and Surveying Company 15