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. Report Number <br /> O DETAILED DAMAGE INSPECTION REPORT $ g - O �Z <br /> U.S. Department Sheet r <br /> l-aid Highways) <br /> of Transportation (Title 23 , Fedora _� of <br /> Federal Highway <br /> Admtnlatretlon FHWA Disaster Number <br /> Location (Name of Road and muspostJ <br /> Inspections Date <br /> Federal-aid Route Number <br /> Description of Damage <br /> ✓�i�oVl 'S K ✓� IIVa--Q C�U �- -�"o rVi eco c ��ea.tl� Y�. UD� ri Ou.� <br /> state County <br /> �-�c� ed � � riz . ��5 o n � y <br /> ,e <br /> Cost Estimate <br /> Cost <br /> Description of Work to Date Unit Unit Price Quantity Completed Remaining <br /> (Equipment, tabor, and Materials) <br /> P <br /> 111 0 <br /> Ila <br /> CL <br /> io <br /> m <br /> E <br /> LU <br /> Subtotal 2 g2=01° <br /> Method PE/CE <br /> Local Forces State Forces Contract <br /> Emergency Repair Total yS'2 DDS. <br /> 0 <br /> IIIIIIIIIIIIn I 111 111111 1111111 1111 11 11111 11111111 <br /> ca <br /> 0 <br /> H <br /> CD <br /> r <br /> C <br /> D) <br /> C <br /> M <br /> E <br /> CL <br /> Subtotal <br /> Method PE/CE <br /> Local Forces State Forces Contract Right-of-Way <br /> Perm. Repair Totals <br /> Environmental Assessment Recommendation Estimated TotalWo 4821 a <br /> LJ Categorical Exclusion [� EA/EIS <br /> FHWDate <br /> A E <br /> Recommendation <br /> Eligible E] Ineligible Date <br /> Concurrence State ngineer <br /> eElls No , <br /> Local Age Rep oe a tativ' a Date <br /> Concurrence C� <br /> yes � No i <br /> Form FHWA-1547 (Rev. 4wl <br />