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Report Number <br /> on DETAILED DAMAGE INSPECTION REPORT <br /> �r sneer i <br /> U .S . DePertrneni (Title 23 , Federal-aid Highways) ( of <br /> of Trensporteti <br /> Fade I HlghwaY FHWA Disaster Number <br /> Administration — y <br /> Location (Name of Road and Mflepost) <br /> inspection Date <br /> �l 0010 (Zo t pi LI) <br /> Federal-aid Route Number <br /> Description of Damage <br /> (n aCt�4d.e �vaSHOU + l ' V,-h� rvvi�CJ , nQ � r�n2 ►�f, State County n <br /> T <br /> Cost Estimate <br /> Cost <br /> Description of work to Date Unit Unit Price Quantity Completed Remaining <br /> (Equipment, Labor, and Materials) w <br /> 2-o alwdid <br /> a <br /> IIIIIII <br /> d <br /> cC <br /> ID <br /> OI <br /> d <br /> E <br /> w <br /> Subtotal 5 000 .r° <br /> Method 206on ct PEKE <br /> Local Forces State Forces Em <br /> ergency Repair Total r <br /> III lid <br /> c <br /> o <br /> m <br /> 0 <br /> N <br /> m <br /> .- <br /> C <br /> C <br /> f0 <br /> E <br /> aSubtotal <br /> Method PE/CE <br /> Local Forces <br /> State Forces Q Contract Right-of-Wey <br /> Perm. Repair Totals <br /> Environm Assessment Recommendation EAlEIS Estimated Total <br /> Categorical Exclusion Date <br /> FHWA Engin <br /> Recommendation <br /> gfble [] Ineligible Date <br /> li <br /> State Engineer / COP 7 ,'- O V <br /> ConcurrenceNo <br /> �s Date <br /> I Concurrence Agency Representatives ' U <br /> es No <br /> Form FHWA-1547 (Rev. 4-98) <br />