G. Crossing Geometrics

Track Skewed Angle = _______	Is there a parallel road to the track? Yes [ ] No [ ]
No. of Tracks = _______	Are there traffic signals within 50'? Yes [ ] No [ ]
Elevated Surface Profile Direction: _________	Is there an entrance/exit within 150'? Yes [ ] No [ ]
Height: _________ in. Direction: _________	Is there a raised median? Yes [ ] No [ ]
Height: _________ in.	Is there curvature on the road or track? Yes [ ]No [ ]

H. Other Information / Attachments

Did you enclose a 8 1/2" x 11"location map?	Yes [ ] No [ ]
Did you enclose two 8"x10" pictures of crossing?	Yes [ ] No [ ]
Did you attach a brief Community Impact evaluation?	Yes [ ] No [ ]