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DETAILED DAMAGE INSPECTION REPORT <br />f.1 DETAILED <br />Number <br />VZ -- MO <br />U.S. Department <br />of TransportationTitle 23, Federal -aid Highways) <br />• Federal Highway <br />Sheet <br />0f <br />Administration <br />Location (Name of Road and Milepost) <br />FHWA Disaster Number <br />-/ 1 (A/ ieViI <br />Inspection Oal ( ''a+'" ( <br />Description of Damage <br />v.)( t (0r A<VE (UE " t`v i -i J tUrisJE- — .e.!' LE <br />Federal -aid Route Number <br />Vie'Vet G t.) S <br />C4 <br />G rlA.,i R -id' Pte- '%rANcT '. -t1Q C <br />State County <br />r -L -81- Te -f -( <br />Cost Estimate <br />Description of. Work to DateCost <br />Price <br />(Equipment, Labor, and Materials) <br />Unit <br />Unit <br />Quantity <br />Completed <br />Remaining <br />$k,..4 em'Ate (,2 r pf..hc&-Le- r <br />it 000� °u© O. <br />•ca <br />a <br />co0 <br />E <br />- <br />w <br />Method Subtotal <br />• <br />Local Forces Q State Forces X Contract PE/CE <br />Emergency Repair Total qt•((000MO <br />P <br />c <br />0 <br />o <br />N <br />• <br />0 <br />rtc <br />0 <br />c <br />m <br />E <br />0 <br />a <br />Method Subtotal <br />• <br />PE/CE <br />Local Forces ❑ State Forces 0 Contract <br />Right -of -Way <br />Perm. Repair Totals. <br />En <br />Ir mental Assessment Recommendation <br />Categorical Exclusion ' Q EA/EIS <br />/ Estimated Total <br />11p: <br />000 • <br />�/ / 01:10 <br />Recommendation <br />(Eligible Ineligible <br />FHWA Eng) : <br />C% <br />Date/ /� r� <br />(c/ v -i. <br />Concurrence <br />IJ Yes Q No• <br />Stat -nginee <br />,� \5---� <br />• <br />DatI <br />I C l/° t/ <br />Concurrence :,. .. <br />'fes; <br />No, <br />[Agency epresentati <br />:;f, ..�" - . .. .. <br />Date ; .. <br />/C G a/.. ... <br />Form FHWA-1547 (Rev. 4-98) <br />