## Review of Local Agency Bridge Inspection Program

  ----------------------------------- -----------------------------------
  Agency                              Date\
                                       

  Agency HQ Location                  Team
  ----------------------------------- -----------------------------------

> BIOH - Bridge Inspection Organizational Head\
> BITL - Bridge Inspection Team Leader\
> BITM - Bridge Inspection Team Member

A.  **Qualifications of Inspection Personnel**

    -   Who is the head of the bridge inspection organization?

  ----------------------------------- -----------------------------------
  A                                   Title:\
                                       

  ----------------------------------- -----------------------------------

-   Who inspects bridges for the agency?

  ----------------------------------- -----------------------------------
  B                                   BITL / BITM Title:\
                                       

  C                                   BITL / BITM Title:\
                                       

  D                                   BITL / BITM Title:\
                                       

  E                                   BITL / BITM Title:\
                                       
  ----------------------------------- -----------------------------------

-   How many years of bridge inspection experience?

  -------------- --------------- --------------- --------------- ---------------
  **Years of                                                     
  Experience**                                                   

                 **0-1**         **2-5**         **6-9**         **10 or more**

  A                                                               

  B                                                               

  C                                                               

  D                                                               

  E                                                               
  -------------- --------------- --------------- --------------- ---------------

>  

-   Is the BIOH/BITL a Registered Professional Engineer?

  ----- ----------- ------------- ----------- -------------- ---------------
  a\.   BIOH -      Yes \_\_\_    No \_\_\_   PE \# \_\_\_   State \_\_\_

  b\.   BITL -      Yes \_\_\_    No \_\_\_   PE \# \_\_\_   State \_\_\_
  ----- ----------- ------------- ----------- -------------- ---------------

-   OR, is the BIOH/BITL qualified for registration as a professional
    engineer under the laws of this State?

>  

  ------- ------------------- ----------------------- --------------------
  a\.     BIOH -              Yes \_\_\_              No \_\_\_

  b\.     BITL -              Yes \_\_\_              No \_\_\_
  ------- ------------------- ----------------------- --------------------

>  

-   Is the BITL currently certified as a Level III or Level IV Bridge
    Safety Inspector under the National Society of Professional
    Engineers\' program for National Certification in Engineering
    Technologies (NICET).

>  

  ------------------------------------- ---------------------------------
  Yes \_\_\_                            No \_\_\_

  ------------------------------------- ---------------------------------

>  

-   What training have bridge inspectors received in bridge inspection?

>  

  ----------- ---------- ------------- ------------ -------------- ----------- -------------- -----------
  **BRIDGE                                                                                    
  INSPECTOR                                                                                   
  TRAINING                                                                                    
  (Dates)**                                                                                   

              **2-week   **Br. Insp\'n **Fracture   **Underwater   **Stream    **BMS          **Other**
              BITC**     Refresher**   Critical**   Inspection**   Stability & Inspection**   
                                                                   Scour**                    

  A                                                                                            

  B                                                                                            

  C                                                                                            

  D                                                                                            

  E                                                                                            
  ----------- ---------- ------------- ------------ -------------- ----------- -------------- -----------

>  

-   Please indicate the bridge inspection assignments (experience) for
    the BITL.

>  

  -------------------- ------------ -------------------------------------
  **Assignments                     
  (Experience)**                    

  **No. of Months**    **Job        **Brief Description of Duties**
                       Title**      

                                     

                                     

                                     

                                     
  -------------------- ------------ -------------------------------------

>  

-   How often is the BITL at the bridge site during inspection?

  ------------------------------------------------ ----------------------
  Always                                           \_\_\_\_\_\_

  Most of the time                                 \_\_\_\_\_\_

  Occasionally                                     \_\_\_\_\_\_

  Never                                            \_\_\_\_\_\_
  ------------------------------------------------ ----------------------

B.  **Available Resources**

    -   How many bridges is the agency responsible for inspecting?

  -------------- ----------- --------------- ---------------- ------------------------
                 **Total**   **Fracture      **Underwater**   **Other Special
                             Critical**                       Inspections**

  **NBI                                                        
  Bridges**                                                   

  **Bridges \<                                                 
  20 ft**                                                     

  **TOTAL**                                                    
  -------------- ----------- --------------- ---------------- ------------------------

>  

-   How many inspections were performed during the last calendar year?

-   How many inspections are scheduled for the upcoming calendar year?

-   Indicate the percentage of time spent on the listed duties in the
    last calendar year:

  --- ---------------- ---------- ---------------- --------------- ----------- ------
      **Bridge         **Bridge   **Bridge         **Bridge        **Other**    
      Inspection and   Design**   Construction**   Maintenance**               
      Rating**                                                                 

  A                                                                            100%

  B                                                                            100%

  C                                                                            100%

  D                                                                            100%

  E                                                                            100%
  --- ---------------- ---------- ---------------- --------------- ----------- ------

>  

-   How long does it normally take to reinspect the following
    structure?\
    (exclude travel time and bridge load capacity rating time)

> Three simple spans with total length of 200 feet, multi girder or
> beam, reinforced concrete deck, over local street. Structure is about
> 20 years old.

-   Does the BIT inspect the following structures:

  ------------------------------------- --------- -------- --------- --------------------
                                        **Yes**   **No**   **N/A**   **If yes, how
                                                                     many?**

  Major Bridges                                                       

  Fracture Critical Bridges                                           

  Underwater Components of Bridges                                    
  ------------------------------------- --------- -------- --------- --------------------

>  

-   Are other sections (personnel) called for assistance when inspecting
    the following structures?

  --------------------------------------------- --------- -------- ---------------
  ** **                                         **Yes**   **No**   **Comments**

  Major Bridges                                                     

  Fracture Critical Bridges                                         

  Underwater Components of Bridges                                  
  --------------------------------------------- --------- -------- ---------------

>  

-   What is the status of, and who conducts, evaluations of the
    following?

  -------------- ------------ ------------ ------------- -------------------
                 **No.        **No.        **Who         **No. Posted or
                 Required**   Complete**   Performs?**   Scour Critical**

  Load Ratings                                            

  Scour                                                   
  Evaluations                                            
  -------------- ------------ ------------ ------------- -------------------

>  

-   How many bridges require posting, but have not yet been posted? If
    so, why not?

-   Have action plans been developed for those bridges determined to be
    scour critical?\
    (Please attach a copy of one.)

C.  **Inspection Records**

    -   What type of information is recorded about each inspection?

  ----- ------------------------------------------------- --------- --------
                                                          **Yes**   **No**

  a\.   Time spent on inspection                                     

  b\.   Temperature                                                  

  c\.   Weather                                                      

  d\.   Inspectors\' signatures                                      

  e\.   Other (Please specify)                                       

                                                                     

                                                                     

                                                                     
  ----- ------------------------------------------------- --------- --------

>  

-   Are previous inspection reports available at the site for review?

    a.  Yes \_\_\_

    b.  No   \_\_\_

>  

-   Are the bridge plans carried to the bridge site for review if
    necessary, or are they readily available for review in the bridge
    office?

  ------------------------------------------- --------------- ------------
                                              **Yes**         **No**

  Bridge site                                                  

  Bridge office                                                
  ------------------------------------------- --------------- ------------

>  

-   What forms are used to record the inspection data? (Choose all that
    apply)

  ------------------------------------------------------------ ------------
  (STA) BIS Inventory Data Coding Form                         \_\_\_\_\_

  Bridge Inspection Report Form                                \_\_\_\_\_

  Laptop program                                               \_\_\_\_\_

  Other (specify)                                              \_\_\_\_\_
  ------------------------------------------------------------ ------------

>  

-   List the bridges and files evaluated during this review:

  ------------- -------------------- ------------------- -----------------
                **Bridge Name**      **Structure ID**    **Bridge No.**

  Bridge A                                                

  Bridge B                                                

  Bridge C                                                

  Bridge D                                                

  Bridge E                                                

  Bridge F                                                
  ------------- -------------------- ------------------- -----------------

>  

-   Please summarize the results of reviewing individual bridge
    inspection reports and files for a sampling of bridges:

  ------------------ ---------- ---------- ---------- ---------- ---------- ----------
                     **Bridge   **Bridge   **Bridge   **Bridge   **Bridge   **Bridge
                     A**        B**        C**        D**        E**        F**

  Coding Accuracy                                                            

  Inv. Data Accuracy                                                         

  Narrative                                                                  

  Sketches                                                                   

  Photographs                                                                

  Maint. Needs                                                               
  Ident\'d                                                                  

  Load Ratings                                                               

  Posting Docum.                                                             

  Scour Calcs                                                                
  ------------------ ---------- ---------- ---------- ---------- ---------- ----------

> G- Good; F- Fair; P- Poor; DNA- Does Not Apply; CNE- Could Not
> Evaluate
>
> Comments
>
>  

D.  **Inspection Procedures**

    -   Are written inspection procedures prepared for the BIT?

> Yes \_\_\_\
> No  \_\_\_

-   What written procedures are available at the bridge site or bridge
    office?

  ------------------------------------------- --------- -------- --------------
                                              **Yes**   **No**   **Describe**

  a\. General                                                     

  b\. Special Feature Inspection                                  

  c\. Fracture Critical Inspection                                

  d\. Underwater Inspection                                       

  e\. Major Bridge Inspection                                     

  f\. Other                                                       
  ------------------------------------------- --------- -------- --------------

>  

-   Do you have any special procedures for any specific bridges that
    your team inspects?

  ---------------------------------------------------------- ------------
  Yes (Please specify)                                       \_\_\_

  No                                                         \_\_\_
  ---------------------------------------------------------- ------------

> (Whenever it is determined that the BIT uses specific written
> procedures for a bridge, the review team should obtain a copy and
> attach it to this questionnaire

-   Who determines the depth of inspection if there are no written
    procedures?

  -------------------------------------------------------------- --------
  a\. BITL                                                       \_\_\_

  b\. Head of bridge inspection unit                             \_\_\_

  c\. Other (specify)                                            \_\_\_
  -------------------------------------------------------------- --------

>  

-   How are new written procedures distributed?

  ------------------------------------------------------------ ----------
  a\. Training session                                         \_\_\_

  b\. Mail                                                     \_\_\_

  c\. General Meetings                                         \_\_\_

  d\. Other (Please specify)                                   \_\_\_
  ------------------------------------------------------------ ----------

>  

-   Do BITMs have specific duties conveyed to them by the BITL?

> a\. Yes \_\_\_\
> b. No  \_\_\_
>
> Comments
>
>  
>
>  

E.  **Inspection Equipment**

    -   What equipment does your team have available for \"hands on\"
        access to bridge members?

+------------------------------------------------------------+----+---+
|                                                            | *  | * |
|                                                            | *Y | * |
|                                                            | es | N |
|                                                            | ** | o |
|                                                            |    | * |
|                                                            |    | * |
+------------------------------------------------------------+----+---+
| a\. Ladder                                                 |    |   |
+------------------------------------------------------------+----+---+
| b\. Aerial Lift Platform (\"manlift\")                     |    |   |
+------------------------------------------------------------+----+---+
| c\. Underbridge Inspection Unit (Snooper, UBIT)            |    |   |
+------------------------------------------------------------+----+---+
| d\. Boat                                                   |    |   |
+------------------------------------------------------------+----+---+
| e\. Scaffolding                                            |    |   |
+------------------------------------------------------------+----+---+
| f\. Climbing Gear                                          |    |   |
+------------------------------------------------------------+----+---+
| g\. Other                                                  |    |   |
|                                                            |    |   |
|                                                            |    |   |
+------------------------------------------------------------+----+---+

>  

-   How accessible is the equipment?

  ----------------- -------------- ------------- -------------- ------------
  \(A\) How many                                                
  bridges need a                                                
  UBIT?                                                         

  \(B\) How many                                                
  bridges is it                                                 
  used on? \_                                                   

  **(C)**           **Readily      **Must be     **Must be      **Always
                    Accessible**   Scheduled**   Rented or      Difficult to
                                                 billed to      Obtain**
                                                 Others**       

  a\. Ladder                                                     

  b\. Aerial Lift                                                
  Platform                                                      
  (\"manlift\")                                                 

  c\. Underbridge                                                
  Inspection Unit                                               
  (UBIT)                                                        

  d\. Boat                                                       

  e\. Scaffolding                                                

  f\. Other:                                                     
  ----------------- -------------- ------------- -------------- ------------

>  

-   Does the Agency ever use NDT (excluding visual)? If yes, complete 4
    and 5 below; if no, skip 4 and 5.

> Yes \_\_\_\
> No  \_\_\_

-   If your answer to question (3) is yes, please indicate who is
    responsible for NDT?

  ----------------------------------------------------- -----------------
  a\. Bridge Unit                                       \_\_\_\_\_\_

  b\. Maintenance Unit                                  \_\_\_\_\_\_

  c\. Materials Testing Unit                            \_\_\_\_\_\_

  d\. Other                                             \_\_\_\_\_\_

  e\. Don\'t know                                       \_\_\_\_\_\_
  ----------------------------------------------------- -----------------

>  

-   Who determines the frequency of NDT?

  ---------------------------------------------------- ------------------
  a\. Bridge Unit                                      \_\_\_\_\_\_

  b\. Maintenance Unit                                 \_\_\_\_\_\_

  c\. Materials Testing Unit                           \_\_\_\_\_\_

  d\. Other                                            \_\_\_\_\_\_

  e\. Don\'t know                                      \_\_\_\_\_\_
  ---------------------------------------------------- ------------------

>  

-   What equipment does the BIT normally carry with them to the
    inspection site?

  ------------------------------------------------------ --------- --------
                                                         Yes       No

  Extension ladder                                       \_\_\_    \_\_\_

  Measuring tape                                         \_\_\_    \_\_\_

  6\' folding rule                                       \_\_\_    \_\_\_

  100\' fiberglass tape                                  \_\_\_    \_\_\_

  Geologist hammer                                       \_\_\_    \_\_\_

  Inspection mirror                                      \_\_\_    \_\_\_

  Flashlight                                             \_\_\_    \_\_\_

  Thermometer                                            \_\_\_    \_\_\_

  Plumb bob                                              \_\_\_    \_\_\_

  Camera                                                 \_\_\_    \_\_\_

  2\'-0\" level (carpenter)                              \_\_\_    \_\_\_

  Brush hook/machete                                     \_\_\_    \_\_\_

  First Aid kit                                          \_\_\_    \_\_\_

  Wire brush                                             \_\_\_    \_\_\_

  Calipers                                               \_\_\_    \_\_\_

  Shovel                                                 \_\_\_    \_\_\_

  Screw driver                                           \_\_\_    \_\_\_

  Pliers                                                 \_\_\_    \_\_\_

  Wrenches                                               \_\_\_    \_\_\_

  Incremental borer                                      \_\_\_    \_\_\_

  Deck sounding chains                                   \_\_\_    \_\_\_

  Hip boots & waders                                     \_\_\_    \_\_\_

  Paint stick/keel                                       \_\_\_    \_\_\_

  Scraper                                                \_\_\_    \_\_\_

  Feeler gauge                                           \_\_\_    \_\_\_

  Probing rod                                            \_\_\_    \_\_\_

  Vertical clearance measuring rod                       \_\_\_    \_\_\_
  ------------------------------------------------------ --------- --------

> List additional items below
>
>  

F.  **Follow-up Procedures**

    -   Do Agency maintenance personnel accompany the BIT on
        inspections?

  --------------------------------------- -------------------------------
  \_\_\_ Always                           \_\_\_ Occasionally

  \_\_\_ Most of the time                 \_\_\_ Never
  --------------------------------------- -------------------------------

>  

-   Are recommendations for maintenance or repairs identified on the
    bridge inspection form?

> \_\_\_ Yes    \_\_\_ No

-   Does the BIT assess whether previous maintenance problems have been
    corrected?

> \_\_\_ Yes    \_\_\_ No

-   How do you call the attention of maintenance personnel to routine
    bridge maintenance problems?

> \_\_\_ Written procedure    \_\_\_\_ Verbally    \_\_\_\_ Regularly
> scheduled meetings

-   How is the BIOH notified of needed repairs, and how and to whom are
    completed repairs communicated?

>  

-   Who does the BITL notify when emergency repairs are necessary?

  -------------------------------- --------------------------------------
  \_\_\_ Bridge Section            \_\_\_ Other

  \_\_\_ Maintenance Section       \_\_\_ Not required to notify anyone
  -------------------------------- --------------------------------------

>  

-   If a bridge requires emergency repairs, is this noted as part of the
    inspection report or as a separate document?

> \_\_\_ BIR    \_\_\_ Separate document    \_\_\_ Not documented

-   What procedures and documentation are in place to insure timely
    correction of emergency needs?

-   Who checks proper placement of signs (load posting, clearance, speed
    restriction, narrow bridge etc.)?

  -------------------------------------------- --------------------------
  \_\_\_ BIT                                   \_\_\_ Other

  \_\_\_ Bridge Section                        \_\_\_ Don\'t know

  \_\_\_ Maintenance Section                   
  -------------------------------------------- --------------------------

>  

-   What is the annual bridge maintenance budget?

>  
>
> **Review Summary**

  ---------------------- -------------- -------------------- ------------------
  **Category**           **Adequate**   **Minor Inadequacies **Not Adequate
                                        (Corrective Action   (Corrective Action
                                        Desirable)**         Imperative)**

  A. Qualification of                                         
  Inspection Personnel                                       

  B. Available Resources                                      

  C. Inspection Records                                       

  D. Inspection                                               
  Procedures                                                 

  E. Inspection                                               
  Equipment                                                  

  F. Follow-up                                                
  Procedures                                                 

  G. Condition/Appraisal                                      
  Ratings                                                    
  ---------------------- -------------- -------------------- ------------------

> **Summary Comments**
>
>  
>
>  
>
> **Inspection Report Evaluation Form**

  ----------------------------------- -----------------------------------
  Bridge Name:                        Evaluated by:

  Structure ID No.:                   Date:
  ----------------------------------- -----------------------------------

-   Please indicate whether the following information is included in the
    most recent inspection report:

  ----------------------------------------------- --------- -------- ---------------
                                                  **Yes**   **No**   **Not
                                                                     applicable**

  a\. Narrative Section                                               

  b\. Sketches of cracks, spalls exposed rebar,                       
  etc.                                                               

  c\. Bridge Photographs                                              

  d\. Maintenance needs identified                                    

  e\. Emergency repairs required                                      

  f\. Posting signs documented                                        
  ----------------------------------------------- --------- -------- ---------------

>  

-   Are the sketches identified in (1b) of sufficient detail to track
    changes in the bridge (joint opening measurements, widths of cracks
    etc.)?

> a\. Yes \_\_\_\
> b. No \_\_\_

-   Do the condition and appraisal ratings from the current inspection
    report agree with the condition and appraisal ratings on the
    Agency\'s most recent SI&A sheet? (This question evaluates if the
    inspection data is reliably captured into the State\'s bridge
    inventory database.)

> Yes \_\_\_\
> No \_\_\_

-   Does the inspection form list the members of the BIT?

> e\. Yes \_\_\_\
> f. No \_\_\_

-   Is the inspection form signed and dated?

> e\. Yes \_\_\_\
> f. No \_\_\_

-   What are the dates of the previous 5 routine inspections?

> \_\_\_\_\_      \_\_\_\_\_      \_\_\_\_\_      \_\_\_\_\_     
> \_\_\_\_\_     
>
> **Inspection File Evaluation**

-   **Written Procedures**

> a\. Are written inspection procedures required for this bridge? If no,
> skip the rest of this section

-   Evaluate the following:

> Critical inspection locations identified
>
> Inspection frequencies identified
>
> Inspection methods identified
>
> Discussion of deficiencies to look for
>
> Special equipment needs identified

-   **Load Rating Calculations**

> What is the method used for calculating the load rating?
>
> Is the HS truck used with the Load Factor method to determine
> Inventory & Operating Ratings?
>
> What are the calculated ratings:

  ------------------- ------------------ --------------------------------
                      **Inventory**      **Operating**

  Type 3              \_\_\_\_\_         \_\_\_\_\_ (25.0 Tons)

  Type 3-S2           \_\_\_\_\_         \_\_\_\_\_ (36.7 Tons)

  Type 3-3            \_\_\_\_\_         \_\_\_\_\_ (43.2 Tons)

  HS Truck            \_\_\_\_\_         \_\_\_\_\_
  ------------------- ------------------ --------------------------------

>  
>
> What is the recommended load posting? Is it physically posted?
>
> Is the load rating signed and stamped by a registered P.E.?

-   **Scour Evaluation**

> Has scour been evaluated in accordance with acceptable practice?
>
> If the bridge is scour critical, has a written action plan been
> developed addressing:

-   Monitoring

-   Installation of temporary countermeasures

-   Permanent countermeasures

>