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Report Number <br /> DETAILED DAMAGE INSPECTION REPORT MMMMMMMMMM S$$ - OLL <br /> U.S. Department <br /> Sheet <br /> of Transportation (Title 23 , Federal -aid Highways t of <br /> Federal Highway <br /> Administration FHWA Disaster Number <br /> Location (Name of Road and Milepost) F L - D uoweDy <br /> 23 rd �reC,+ 5W ) Q.+ 21 5W Inspection Date <br /> �hl� rc� � e io - 2(0 - 044 <br /> Federal-aid Route Number <br /> Description of Damage <br /> luer-�- due. 410L,).n i mrnr� e <br /> State County <br /> Ft. � $ Zr�cL (an Q,'. �cr <br /> Cost Estimate <br /> Cost <br /> Description of Work to Date Unit Unit Price Quantity Completed Remaining <br /> (Equipment, Labor, and Materials) o. <br /> 2 2 l0"1 . 7z P5 ppO. <br /> dAn <br /> �-� <br /> a <br /> d <br /> lr <br /> T <br /> U <br /> C <br /> m <br /> L <br /> E <br /> w <br /> Subtotal 152 267. 7" <br /> Method PENCE <br /> Local Forces Q State Forces LJ �on� I �y <br /> Emergency Repaft Total <br /> MM <br /> c <br /> 0 <br /> ICU IIIIII <br /> L <br /> 0 <br /> .r <br /> y <br /> N - <br /> C <br /> d <br /> C <br /> L6 <br /> E <br /> L <br /> tCD Subtotal <br /> Method PENCE <br /> Local Forces State Forces Contract Right-of-Way <br /> Perm, Repair Totals <br /> Environments Assessment Recommendation 152 2 (p7. 75� <br /> DodaExclusion Q . ENEIS Estimated Total i <br /> Date <br /> FHWAE <br /> Recommendation, / <br /> Eligible Ineligible Date <br /> Concurrence State Engineer > _ !O MM", y <br /> Yes No (!_ <br /> Date <br /> i Agen epresentative ( O , Z� r O <br /> Concurrence � No <br /> Zas' <br /> Form FHWA-1547 (Rev. 4-98) <br />