Bridge Inspection: Download Template | Lumiform

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Bridge Inspection

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Audit

Bridge #

Select date

Photo 1 - Upstream Face

Photo 2 - Downstream Face

Photo 3 - Approach From North/West

Photo 4 - Approach From South/East

Photo 5 -

Photo 6 -

BRIDGE ENDS

Bridge Open/Posted/Closed

Posting Signs Required?

Posting Signs in Place?

Bridge Rail (36a)

Rail Transition (36b)

Approach G'Rail (36c)

Guard Rail Ends (36d)

Bridge End General Comments:

Additional Photo If Necessary

DECK

Joint Condition

Drain Condition

Rail Condition

Sidewalk Condition

Live Load Deflection/Vibration

Debris Accumulation on Deck

Overall Deck Condition

NBI Deck Cond. 9-Excellent; 8-No Problems Noted, 7-Mnr Problems; 6-Mnr Deterioration; 5-Mnr Cracking; 4-Adv Deterioration; 3-Loss of Section; 2-Monitor Closely/Close Til Repair; 1-Br Closed til Repair; 0-Beyond Repair

Deck General Comments

Additional Photo If Necessary

SUPERSTRUCTURE

Girders

Diaphragms

Stringers

Floor Beams

Sway Bracing

Hangers

Paint

Cap/Girder Debris

Collision Damage

Have Flood Waters Reached Superstructure?

NBI Superstructure Cond. 9-Excellent; 8-No Problems Noted, 7-Mnr Problems; 6-Mnr Deterioration; 5-Mnr Cracking; 4-Adv Deterioration; 3-Loss of Section; 2-Monitor Closely/Close Til Repair; 1-Br Closed til Repair; 0-Beyond Repair

General Super Structure Comments

Additional Photo If Necessary

SUBSTRUCTURE

Abutments

Bearings

Cap

Piling Foundations

Pile Type

Back Wall

Embankment

Slope Protection

Scour

Additional Photo if Necessary

Intermediate Bents

Bearings

Cap

Piles/Columns

Pile Type

Footings

Web Walls

Bracing

Scour

Additional Photo if Necessary

NBI Substructure Cond. 9-Excellent; 8-No Problems Noted, 7-Mnr Problems; 6-Mnr Deterioration; 5-Mnr Cracking; 4-Adv Deterioration; 3-Loss of Section; 2-Monitor Closely/Close Til Repair; 1-Br Closed til Repair; 0-Beyond Repair

Underwater Inspection Req'd?

General Substructure Comments

Scour/Waterway Appraisal

Scour Critical (113)

Scour Indicator Notes: (Describe scour condition)

Scour Countermeasures in Place?

Debris/Drift Upstream?

Debris/Drift Site?

Debris/Drift Downstream?

Overall Channel Condition

Indications that High Waters Overtop Structure and/or Approach Roadway?

Waterway Adequacy (71) 9-Chance of O.T. Remote; 8-Slight Chance of O.T. Approaches; 7-Slight Chance of O.T. Bridge; 6-Approach Only O.T., Insign. Delay; 5-Approach Only O.T., Sign. Delay; 4-Occas. Br & Appr. w/ Sign. Delay; 3-Freq. O.T. of Br. & Appr. w/ Sign. Delay; 2-Freq. O.T., Sev. Delay; 0-Br. Cl.

NBI Channel Rating (61) 9-No Deficiencies; 8-Stable Condition; 7-Bank Needs Minor Repair; 6-Bank Slumping, Light Debris; 5-Bank Eroding, Moderate Debris; 4-Severe Damage; Large Amts of Debris; 3-Bank Failed, Threatening Br.; 2-Br. Near Collapse; 1-Br. Closed Due to Channel; 0-Br. Perm. Closed

Route Functional Classification (26)

General Waterway/Scour Comments:

Additional Photo if Necessary

Inspection Team Summary

General Notes

Additional Photo if Necessary

Team Leader

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