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Report Number <br /> DETAILED DAMAGE INSPECTION REPORT <br /> =Administration <br /> (Title 23, Federal-aid Highways ) sheet <br /> of <br /> Location (Name of Road and Milepost) FHWA Disaster Number <br /> L - Ate{ O <br /> / %t leWC=Vt cowr%lI Inspection Dat <br /> Description of Damage Federal-aid Route Number <br /> �`j � Cq (•( �f'*!''LA�r'1� �L3(JE ""Cra i-��JR�.�C�1'r�t�' ^�-�� '�/iPC +� I oto S <br /> State County <br /> Cost Estimate <br /> Description of Work to Date Unit Unit Price Quantity Cost <br /> (Egyipment, Labor, and Materials) Completed Remaining <br /> m <br /> a <br /> U <br /> C <br /> ID - <br /> Ol <br /> D) <br /> E <br /> LU <br /> Method Subtotal <br /> Local Forces State Forces Contract PEKE <br /> Emergency Repair Total ( pfl too 10 <br /> c ' <br /> 0 <br /> L° <br /> p <br /> N ' <br /> a) <br /> w <br /> C <br /> d <br /> C <br /> co <br /> E <br /> Q1 <br /> D_ <br /> Method Subtotal <br /> Local Forces State Forces Contract PE/CE <br /> Right-of--Way <br /> Perm. Repair Totals- <br /> Envir nmental Assessment Recommendation <br /> Categorical Exclusion EA/EIS Estimated Total /i L iso' <br /> Recommendation FHWA Eng' r Date <br /> MEligible ineligible ( c1& 116�0( <br /> Concurrence Stat nginee Da <br /> Yes No <br /> Concurrence . . LAgency epresentativ Date <br /> i--. . G . . <br /> Form FHWA-1547 (Rev. 4-9.8) <br />