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Report Number <br /> DETAILED DAMAGE INSPECTION REPORT j ? .g <br /> U.S. Department Sheet <br /> of Transportation (Title 23 , Federal-aid Highways) l of <br /> Federal Highway <br /> Administration <br /> Location (Name of Road and Milepost) FHWA Disaster Number <br /> • farf- o 27+h Au e F Lw Q LI - D1-/ <br /> 2 arc if Vt ro AJC � e jefY1 tk +Q1r y Inspection Date <br /> 0 .+ 21 G-4 -Io 20 }k e I O - 2. 6 ` 044 <br /> Description of Damage Federal4d Route Number <br /> 6ad'5;C(k ojo'shou4t) civt -}c� -ur-,rica >� e JeQn� e <br /> State county <br /> s�clr0 ,1 eluty <br /> Cost Estimate <br /> - Cost <br /> Description of Work to Date Unit Unit Price Quantity <br /> (Equipment, Labor, and Materials) Completed Remaining <br /> Lai <br /> 2 !� <br /> CIS �Q <br /> t rqA 1 ,C <br /> U _ <br /> 5t 2 + e o CA. =° <br /> E U I - OvO . <br /> 2. i �o � e <br /> Method Subtotal '4 0 000 . <br /> Local Forces State Forces [Contract PE/CE <br /> Emergency Repair Total 40 00b a' <br /> C <br /> O <br /> to <br /> O <br /> N <br /> d <br /> C <br /> d , <br /> C <br /> M <br /> G1 <br /> 4 <br /> Method Subtotal <br /> PE/CE <br /> Local Forces State Forces Contract Right-of--Way <br /> Perm . Repair Totals <br /> Environme talAssessmentRecommendation `r0 01D0 . 0 <br /> 0[Categorical Exclusion EA/EIS Estimated Total -7 + <br /> Recommendation <br /> FHWZEEDate <br /> op <br /> dEligible Ineligible � <br /> Date <br /> Concurrence State Engineer <br /> Yes No <br /> Concurrence Local Agency Re r <br /> esentativ ^ Date <br /> as No <br /> Form FHWA•1547 (Rev. 448) <br />