WESTERN FEDERAL LANDS HIGHWAY DIVISION\
HIGHWAY DESIGN STANDARDS

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<tbody>
<tr class="odd">
<td colspan="12">Project Number and Name:</td>
<td colspan="18"><u>     </u></td>
</tr>
<tr class="even">
<td colspan="5">Location:</td>
<td colspan="25"><u>     </u></td>
</tr>
<tr class="odd">
<td colspan="9">Type of Project:</td>
<td colspan="6"> New Construction</td>
<td colspan="8"> Reconstruction</td>
<td colspan="7"> RRR</td>
</tr>
<tr class="even">
<td colspan="9">Description of Work:</td>
<td colspan="21"><u>     </u></td>
</tr>
<tr class="odd">
<td colspan="4" rowspan="2">System:</td>
<td colspan="9"> Forest Service</td>
<td colspan="10"> National Park Service</td>
<td colspan="7" rowspan="2"> <u>Other (describe)</u></td>
</tr>
<tr class="even">
<td colspan="13"> National Highway System (NHS)</td>
<td colspan="6"> Non NHS</td>
</tr>
<tr class="odd">
<td colspan="11">Functional Classification:</td>
<td colspan="19"><u>     </u></td>
</tr>
<tr class="even">
<td colspan="7">Owner Agency:</td>
<td colspan="23"><u>     </u></td>
</tr>
<tr class="odd">
<td colspan="3"></td>
<td colspan="7"></td>
<td colspan="11"><h1 id="adt">ADT</h1></td>
<td colspan="6"><strong>PERCENT TRUCKS</strong></td>
<td></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3"></td>
<td colspan="3">TRAFFIC</td>
<td colspan="4">YEAR</td>
<td colspan="4">AVERAGE</td>
<td colspan="5">SEASONAL</td>
<td colspan="2">DHV</td>
<td colspan="4">DHV</td>
<td colspan="2">ADT</td>
<td>D</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3"></td>
<td colspan="3">Current</td>
<td colspan="4">     </td>
<td colspan="4">     </td>
<td colspan="5">     </td>
<td colspan="2">     </td>
<td colspan="4">     </td>
<td colspan="2">     </td>
<td>     </td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3"></td>
<td colspan="3">Future</td>
<td colspan="4">     </td>
<td colspan="4">     </td>
<td colspan="5">     </td>
<td colspan="2">     </td>
<td colspan="4">     </td>
<td colspan="2">     </td>
<td>     </td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="7">Design Standards:</td>
<td colspan="6"> AASHTO</td>
<td colspan="4"> NPS</td>
<td colspan="12"> <u>Other (describe)</u></td>
</tr>
<tr class="even">
<td></td>
<td colspan="3">Terrain:</td>
<td colspan="16"></td>
<td colspan="4">Design Speed:</td>
<td colspan="6"><u>     </u></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="19">Posted or Regulatory Speed Limit: <u>?? MPH [??
km/h]</u></td>
<td colspan="10">Exception: <u>     </u></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="14">GEOMETRIC AND BRIDGE CRITERIA</td>
<td colspan="6">STANDARD</td>
<td colspan="4">AS DESIGNED</td>
<td colspan="3">EXCEPTION</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="14">Traveled Way Width</td>
<td colspan="6">?</td>
<td colspan="4">??</td>
<td colspan="3">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="14">Shoulder Width</td>
<td colspan="6">?</td>
<td colspan="4">??</td>
<td colspan="3">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="14">Crown</td>
<td colspan="6">2%</td>
<td colspan="4">2%</td>
<td colspan="3">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="14">Horizontal Curvature</td>
<td colspan="6">?</td>
<td colspan="4">??</td>
<td colspan="3">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="14">Superelevation</td>
<td colspan="6"><p>e(max) = ?%</p>
<p>Δ = 0.??%</p></td>
<td colspan="4"><p>e(max) = ?%</p>
<p>Δ = 0.??%</p></td>
<td colspan="3">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="14">Grades</td>
<td colspan="6">?%</td>
<td colspan="4">?%</td>
<td colspan="3">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="14">Vertical Curvature</td>
<td colspan="6">K(crest) = ? K(sag) = ?</td>
<td colspan="4">K(crest) = ?? K(sag) = ??</td>
<td colspan="3">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="14">Stopping Sight Distance</td>
<td colspan="6">     </td>
<td colspan="4">     </td>
<td colspan="3">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="14">Horizontal Clearance to Structure (not clear zone)</td>
<td colspan="6">     </td>
<td colspan="4">     </td>
<td colspan="3">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="14">Vertical Clearance to Structure</td>
<td colspan="6">     </td>
<td colspan="4">     </td>
<td colspan="3">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="14">Bridge Width</td>
<td colspan="6">?</td>
<td colspan="4">??</td>
<td colspan="3">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="14">Bridge Loading</td>
<td colspan="6">     </td>
<td colspan="4">     </td>
<td colspan="3">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="14">Bridge Railing</td>
<td colspan="6">NCHRP-350</td>
<td colspan="4">     </td>
<td colspan="3">     </td>
<td></td>
</tr>
</tbody>
</table>

Descriptions of and reasons for exceptions to standards:

Analysis of risks and design considerations proposed to mitigate
exceptions:

Describe guidelines used and any variances from recommended Roadside
Design (clear zone, guardrail) guidelines:

RECOMMENDED ACTION:

There are no exceptions to applicable standards, and the project should
proceed with the final PS&E.

There are exceptions to standards as listed on the front sheet and these
exceptions have been reviewed with the appropriate client, cooperators,
and interested agencies and parties, and are considered acceptable.

PREPARED BY:

Date Lead Designer

APPROVAL IS RECOMMENDED:

Date      

Date Highway Standards Engineer

I CONCUR WITH THE ABOVE RECOMMENDATIONS:

Date \...Official from maintaining agency\...

Date Project Development Engineer

THE ABOVE RECOMMENDATIONS ARE APPROVED:

Date Director, Project Delivery