C. Speed Reduction or Slow Order
Vehicle Speed Reduction |
mph |
Railroad Slow Order |
mph |
Is there a center divider? |
Yes [ ] No [ ] |
E. Average Daily Vehicle & Train Volumes
Transportation Mode |
COUNT |
COUNT DATE |
Total Number of Vehicles |
| |
Total Number of Trains |
||
Freight Trains |
||
Passenger Trains |
||
Light Rail Trains |
D. Accident History Data
Total Number of Trains vs. Vehicle Accidents * | |||
Source |
Date |
Killed |
Injured |
Source |
Date |
Killed |
Injured |
Source |
Date |
Killed |
Injured |
Source |
Date |
Killed |
Injured |
* List all accidents from October 21, 1996 to October 21, 2005. For each accident specify the accident date, the number of fatalities and injuries.
G. Costs and Contributions
Please fill in the following worksheet to determine the total project costs.
Right-of Way allowance............................$________________
Preliminary Engineering............................$________________
Construction Engineering..........................$________________
Total Engineering ............................ $_______________________
Bridge Construction.................................. $________________
Railroad Work........................................... $________________
Highway Approaches & Connections.....$________________
Utility Relocation........................................$________________
Contingencies..............................................$________________
Removing Existing Crossing......................$________________
Total Construction Costs.....................$_______________________
TOTAL PROJECT COSTS $______________________
ALLOCATED SHARE FROM STATE FUND: $______________________
Contributions:
City |
$ |
County |
$ |
Railroad |
$ |
Other (specify) |
$ |
H. Probability of Failure
Specify the date that the structure was built? |
|
When was structure last evaluated? * |
|
Has the structure been retrofitted to current standards for seismic safety or other improvements? ** If so, indicate completion date of retrofit work. |
Yes [ ] No [ ] |
* Please attach a copy of the evaluation results with recommendations for corrective action(s).
** Please attach a summary of work performed and completion date(s).
I. Attachments
Did you enclose an 8 ½" x 11" location map? |
Yes [ ] No [ ] |
Did you enclose two 8"x10" pictures of crossing? |
Yes [ ] No [ ] |
