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STR 1638 (Chippewa Co.)
Gogomain Road over Munuscong River
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* Indicates required question
Email
*
Your email
Inspector Name
*
Your answer
Agency / Company Name
*
Your answer
Date field inspection was performed:
*
MM
/
DD
/
YYYY
What condition rating best describes the Surface (SIA-58A)?
*
0
1
2
3
4
5
6
7
8
9
N
Select ALL Deck/Slab elements that should be included in the AASHTO Element Report:
*
800 Reinforced Concrete Black Bars
60 Other Deck
15 Prestressed Concrete Top Flange
16 Reinforced Concrete Top Flange
840 Reinforced Concrete Sidewalk
816 Thin Overlay
817 Asphalt Overlay w/ Membrane
300 Strip Seal Expansion Joint
301 Pourable Joint Seal
302 Compression Joint Seal
Required
What condition rating best describes the Expansion Joint(s)?
*
0
1
2
3
4
5
6
7
8
9
N
What condition rating best describes the Other Joint(s)?
*
0
1
2
3
4
5
6
7
8
9
N
What condition rating best describes the Railings?
*
0
1
2
3
4
5
6
7
8
9
N
How many CS2 cracks were present on the bridge railing? Please select the best answer.
*
3
35
72
108
241
What condition rating best describes the Deck Bottom Surface (SIA-58B)?
*
0
1
2
3
4
5
6
7
8
9
N
What condition rating best describes the Deck (SIA-58)?
*
0
1
2
3
4
5
6
7
8
9
N
Deck Rating Comments:
*
Your answer
What condition rating best describes the Superstructure (SIA-59)?
*
0
1
2
3
4
5
6
7
8
9
N
Superstructure Rating Comments:
*
Your answer
Select ALL defects present on the superstructure:
*
Spalls/Delaminations/Cracking
Patch Areas
Exposed Rebar
Efflorescence/Rust Staining
Scour
All of the above
Other:
Required
What is the most accurate CONDITION STATE 3 quantity of Prestressed Concrete Box Beams (823)?
*
0 - 20 ft
20 - 50 ft
50 - 100 ft
100 - 200 ft
200 + ft
What condition rating best describes the Paint (SIA-59A)?
*
0
1
2
3
4
5
6
7
8
9
N
What condition rating best describes the Section Loss?
*
0
1
2
3
4
5
6
7
8
9
N
What condition rating best describes the Bearings?
*
0
1
2
3
4
5
6
7
8
9
N
What condition rating best describes the Abutments (SIA-60)?
*
0
1
2
3
4
5
6
7
8
9
N
Abutment Rating Comments:
*
Your answer
Which Condition State Tables should be used for the Substructure Elements included in the AASHTO Element Report? (select all that apply):
*
CS Table 1 - Reinforced Concrete
CS Table 2 - Prestressed Concrete
CS Table 3 - Steel
CS Table 4 - Timber
CS Table 5 - Masonry
CS Table 6 - Other Materials
CS Table 7 - Wearing Surfaces
CS Table 8 - Joints
CS Table 9 - Beam End
CS Table 10 - Scour Protection
CS Table 11 - Bearings
CS Table 12 - Protective Systems
CS Table 13 - MSE Abutments
CS Table 14 - Appurtenances
Required
What condition rating best describes the Piers (SIA-60)?
*
0
1
2
3
4
5
6
7
8
9
N
Pier Rating Comments:
*
Your answer
What is the most accurate CONDITION STATE 1 quantity of Reinforced Concrete Pier Cap (234)?
*
0 - 25 ft
25 - 50 ft
50 - 75 ft
75 - 100 ft
100 ft +
Required
What condition rating best describes the Channel (SIA-61)?
*
0
1
2
3
4
5
6
7
8
9
N
What condition rating best describes the Scour Inspection?
*
0
1
2
3
4
5
6
7
8
9
N
Scour Inspection Comments:
*
Your answer
What is the TOTAL quantity of Reinforced Concrete Approach Slab (321)?
*
Your answer
List THREE Work Recommendations with Priority:
*
Your answer
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