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Report Number <br /> EAdministmtIon DETAILED DAMAGE INSPECTION REPORT J' g g - 02- S <br /> Title 23 , Federal-aid Highways ) sneer <br /> of -L <br /> Location ( ameof Road and Milepost) FHWA Disaster Number <br /> n � L. _ p u <br /> Q, 04'1�' Au-mule ( you,+ N 171= S40,+C ZDox � � ) Inspection Date . <br /> 1 - DU <br /> Description of Damage Federal-aid Route Number <br /> ( du damages 6LLtt 4,o Ht, mca ru_ � earnne . <br /> lam Wce 01 state C-oJunty n , <br /> Cost Estimate 7 <br /> Description of Work to Date Unft Unit Price Quantity Cost <br /> (Egyipment, Labor, and Materials) Completed Remaining <br /> PwA wa. rtrxo rs <br /> CL <br /> LUft I/ <br /> d <br /> tY <br /> U <br /> C <br /> a) <br /> m <br /> CD <br /> CD <br /> E <br /> W <br /> Method Subtotal `°'D <br /> Local Forces State Forces 2 Contract PENCE <br /> Emergency Repair Total IS <br /> c • <br /> 0 <br /> ca <br /> o <br /> Cn <br /> CD <br /> CD <br /> c <br /> W <br /> c <br /> m <br /> m <br /> IL <br /> Method Subtotal <br /> Local Forces State Forces Contract PENCE <br /> Right-of--Way <br /> Perm. Repair Totals <br /> Environment Assessment Recommendation 00 <br /> Categorical Exclusion Q -EA/EIS Estimated Total As 150 00 <br /> RecommendationFHWA Enginee Date <br /> Eligible Ineligible 19 - 2to -ot'( <br /> Concurrence State Engineer Date y <br /> R<es No / 11 `�Il'0 <br /> Concurrence Local Ag cY Repres ntative Date <br /> [�'es j No n <br /> ry ,CSd�-rt-•-� o - u - o <br /> Form FHWA4547 (Rev. 4-98) <br />