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U. S. DOT CROSSING INVENTORY FORM DEPARTMENT OF TRANSPORTATION FEDERAL RAILROAD ADMINISTRATION EXHIBIT C OMB No. 2130-0017 Instructions for the initial reporting of the following types of new or previously unreported crossings: For public highway -rail grade crossings, complete the entire inventory Form. For private highway -rail grade crossings, complete the Header, Parts I and 11, and the Submission Information section. For public pathway grade crossings (including pedestrian station grade crossings), complete the Header, Parts I and 11, and the Submission Information section. For Private pathway grade crossings, complete the Header, Parts I and 11, and the Submission Information section. For grade -separated highway -rail or pathway crossings (including pedestrian station crossings), complete the Header, Part I, and the Submission Information section. For changes to existing data, complete the Header, Part I Items 1-3, and the Submission Information section, in addition to the updated data fields. Note: For private crossings only, Part I Item 20 and Part III Item 2.K. are required unless otherwise noted. An asterisk * denotes an optional field. A. Revision Date B. Reporting Agency C. Reason for Update (Select only one) D. DOT Crossing (MM/DD/YYYY) ❑ Railroad ❑ Transit ❑ Change in ❑ New ❑ Closed ❑ No Train ❑ Quiet Inventory Number Data Crossing Traffic Zone Update ❑ State ❑ Other ❑ Re -Open ❑ Date ❑ Change in Primary ❑ Admin. Change Only Operating RR Correction Part I: Location and Classification Information 1. Primary Operating Railroad 2. State 3. County 4. City / Municipality S. Street/Road Name & Block Number 6. Highway Type & No. ❑ In I ❑ Near (Street/Rood Name) I * (Block Number) 7. Do Other Railroads Operate a Separate Track at Crossing? ❑ Yes ❑ No 8. Do Other Railroads Operate Over Your Track at Crossing? ❑ Yes ❑ No If Yes, Specify RR If Yes, Specify RR 9. Railroad Division or Region 10. Railroad Subdivision or District 11. Branch or Line Name 12. RR Milepost ❑ None ❑ None ❑ None -1-1 (prefix) I (nnnn.nnn) I (suffix) 13. Line Segment 14. Nearest RR Timetable 15. Parent RR (if applicable) 16. Crossing Owner (if applicable) * Station ❑ N/A ❑ N/A 17. Crossing Type 18. Crossing Purpose 19. Crossing Position 20. Public Access 21. Type of Train 22. Average Passenger ❑ Highway ❑ At Grade (if Private Crossing) ❑ Freight ❑ Transit Train Count Per Day ❑ Public ❑ Pathway, Ped. ❑ RR Under ❑ Yes ❑ Intercity Passenger ❑ Shared Use Transit ❑ Less Than One Per Day ❑ Private ❑ Station, Ped. ❑ RR Over ❑ No ❑ Commuter ❑ Tourist/Other ❑ Number Per Day_ 23. Type of Land Use ❑ Open Space ❑ Farm ❑ Residential ❑ Commercial ❑ Industrial ❑ Institutional ❑ Recreational ❑ RR Yard 24. Is there an Adjacent Crossing with a Separate Number? 25. Quiet Zone (FRA provided) ❑ Yes ❑ No If Yes, Provide Crossing Number ❑ No ❑ 24 Hr ❑ Partial ❑ Chicago Excused Date Established 26. HSR Corridor ID 27. Latitude in decimal degrees 28. Longitude in decimal degrees 29. Lat/Long Source ❑ N/A (WGS84 std: nn.nnnnnnn) (WGS84 std: -nnn.nnnnnnn) ❑ Actual ❑ Estimated 30.A. Railroad Use * 31.A. State Use 30.B. Railroad Use * 31.B. State Use 30.C. Railroad Use * 31.C. State Use 30.D. Railroad Use * 31.D. State Use 32.A. Narrative (Railroad Use) * 32.13. Narrative (State Use) 33. Emergency Notification Telephone No. (posted) 34. Railroad Contact (Telephone No.) 35. State Contact (Telephone No.) Part II: Railroad Information 1. Estimated Number of Daily Train Movements 1.A. Total Day Thru Trains 1.B. Total Night Thru Trains1.C. Total Switching Trains 1.D. Total Transit Trains 1.E. Check if Less Than (6 AM to 6 PM) (6 PM to 6 AM) One Movement Per Day El How many trains per week? 2. Year of Train Count Data (YYYY) 3. Speed of Train at Crossing 73.B. 3.A. Maximum Timetable Speed (mph) Typical Speed Range Over Crossing (mph) From _ to 4. Type and Count of Tracks Main Siding Yard Transit Industry S. Train Detection (Main Track only) ❑ Constant Warning Time ❑ Motion Detection ❑AFO ❑ PTC ❑ DC ❑ Other ❑ None 6. Is Track Signaled? 7.A. Event Recorder 7.6. Remote Health Monitoring ❑ Yes ❑ No I ❑ Yes ❑ No ❑ Yes ❑ No FORM FRA F 6180.71 (Rev. 3/15) OMB approval expires 01/31/2026 Pagel OF 2