General Inspection Checklist

 Preliminary Inspection  Grading Inspection  R/W & Engineering Inspection  Final Plan Inspection

Filled out ( * items ) prior to the field inspection and cross off items not applicable.

Date & Time of Inspection: ______

Location of Inspection: ______

Project Number:

______

Inspection Personnel: ______

______

1 Issued Apr_ 2008 General Inspection Checklist

PROPOSED CONSTRUCTION

*A. This project is scheduled for the in ______(Month, Year)

*B. This project is due in the Check Squad ______(Month, Day, Year)

C. Are there special conditions affecting working time of scheduling.

D. Estimated Construction Cost $______

E. Are City and/or County agreements needed?  Yes

 No

F. Work to be done by City and/or County forces prior to, or during construction.

G. Maintenance responsibilities upon completion of project (City, County, or WYDOT)

EARTHWORK

*A. Soils Profile received:

 Yes

 No

*B. Clearing and Grubbing:

1.  ACRE  LS (Explanation required)

2. Clearing trees

(a.) Diameter

*C. Removal of Structures and Obstructions:

*1. Removal of ______

(a.) Method of Payment (List Quantity)

 EA  FT  SY  CY

 TON  LS  Subsidiary  Salvage Value (Approval

required)

(b.) Disposition

Excavation & Embankment:

*1. Borrow

Special

Excavation

 CY

TON 

*(a.) Location

*(b.) Ownership

*(c.) Agreement

*(d.) Samples submitted

 Yes

 No

(e.) Stripping overburden (May be used in fill where large quantity)

(f.) Haul roads

(g.) Haul type

CYMI  TMI

(h.) Dead haul

*2. Muck Excavation

(a.) Limits

(b.) Quantity

(c.) Waste area(s)

(d.) Haul distance

3. Rock Excavation

(a.) Blasting required

 Yes

 No

(b.) Special precautions

 Yes

 No

(c.) Use to

constru

 Yes

 No

(d.) Suitable for riprap

 Yes

 No

(e.) Waste area(s)

(f.) Dead haul

(g.) Seismic velocities

(h.) Special techniques  Pre-splitting

 Cushion blasting

4. Unclassified Excavation:

(a.) Excavation below grade

(b.) Limits & location

(c.) Type backfill required

(d.) Quantity (CY)

5. Unclassified Excavation (Excess)

(a.) Quantity (CY)

(b.) Waste area(s)

(c.) Dead haul

6. Embankment Construction

(a.) Shrink factor Limits

(b.) Swell factor Limits

(c.) Additional embankments

 Approaches  Ditch berms  Dikes  Over-exc. backfill

7. Water (MG)

*(a.) Prewetting

 Yes

 No

*(b.) Estimated Quantity/CY ______Gal.

*(c.) Water source(s) ______

(d.) Dust control

 Yes

 No

Gal.______

8. Grade Line

(a.) Vertical control changes (List locations and reasons)

(b.) Excavation below grade

(1.) Location

(2.) Reason

(3.) Type of material

(4.) Depth

(5.) Waste area(s)

(6.) Source of backfill

Old Road Obliteration:

. Location

. Method of measurement  CY

F. Turnouts:

. Mailboxes  Single

Double

Multiple

Cluster

Location(s)

. Scenic

. Schoolbus

G. Guardrail:

 Box

 W-

Cor-Tan

H. Topsoil and Seeding:

*1. Topsoil storing  CY

______

*2. Topsoil placing  CY

______

. Limits  Slope stake - slope stake

 R/W - R/W

. Depth

3. Topsoil borrow  CY ______

4. Seeding a. Limits b. Seeding recommendations from Environmental Services Prior to the Grading Inspection, a form ARequest for Seeding Recommendations@ should be obtained from the WYDOT agronomist. This form is to be filled out with the required information and returned to the agronomist for his/hers use in recommending seeding and erosion protection items for the project. This information should be conveyed to the Resident Engineer.

5. Landscaping SUB-BASE DESIGN

A. Overburden (all pits):

. Removal ______CY

. Placing ______CY

A. Sub-base:

*1. Pit name and/or location

*2. Agreement

*3. Samples submitted:

 Yes  No

4. Special provisions

5. Air quality permit required  Yes  No

6. Crusher Run  Yes  No Crushed  Yes  No Pit Run  Yes

 No

7. Haul  Yes

 No

 CYMI  TMI

BASE COURSE DESIGN

 Crushed  Cement Treated

 Emulsion

Stabilized 

Plant Mix Bit

*A. Pit name and/or location:

*B. Agreement:

*C. Samples submitted:

 Yes

 No

*D. Mineral filler location if required:

A. Lime:

A. Winter protection:

 Yes

 No

A. Special provisions:

A. Air quality permit

required:  Yes

 No

A. Haul:

 Yes

 No

 CYMI  TMI

SURFACING

 Plant Mix  Concrete  Wearing Couse

 Commercial Mix

*A. Pit name and/or location

*B. Agreement

*C. Samples submitted:

 Yes

 No

D. Lime

E. Concrete

1. Source

2. Fly Ash required  Yes  No

3. Placing of concrete and reinforcing

4. Finishing and finishing equipment

5. Joints and placement

E. Mineral filler location if required

F. Seal coat  Yes  No

1. Type  Fog 

Chip  Chip (Overshoot)

2. Shoulder widths  < 4 feet  > 4 feet

E. Blotter  Yes  No

Source:

 Ton  CY

F. Haul  Yes  No

 CYMI  TMI

G. Rumble strips required  Yes

 No

H. Special provisions

I. Air quality permit required  Yes

 No

APPROACHES AND CATTLEGUARDS

*A. Approaches

. Show locations on plans and list in summary form on R/W & Utility Plans

. Included approaches requested by entities B BLM, USFS, etc. ?

*B. Cattleguards

Station on plans Width

Cattleguard &

Type Description

FENCING

. Types Station to Station

______

. Replace in kind

. Type

. Location: Station______to Station______

. Reset existing fence

*B. Special gates (> 16 feet wide B two gates will be required unless recommended

otherwise)

. Location

2. Replace in kind

Location

3. Remove and reset gates

Location

4. Remove existing gates

Location

C. Snow fence

 Reset Snow Fence  Snow Fence Repair  Snow

Fence (Wood)

(Panel lengths and height required for quantity computation) Pay unit = EA

DRAINAGE

A Minor drainage

1. Drainage surveys completed?

 Yes

 No

2. Alkali samples submitted?

 Yes

 No

3. Culvert Design System (CDS) runs complete  Yes  No

4. Erosion Control

Source:

B. Major Drainage

1. Drainage surveys competed?

 Yes

 No

2. Alkali samples submitted?

 Yes

 No

3. Structure selection complete?

 Yes

 No

4. Applications for required water quality certificates and permits submitted by Environmental Services  Yes  No

5. Erosion control

Source:

C. Storm Sewer

*1. Manholes

*2. Drop Inlets

D. Detention Ponds

E. Irrigation structures

1. Landowner contacted?

 Yes

 No

2. Private irrigation easement required?  Yes

 No

3. Separate contract with irrigation district to adjust ditches?

 Yes  No

4 Structure a. Location b. Type (concrete, wood, other) c. Drawing number (WYDOT)

5. Contract items (list)

 Force account  Lump sum

Subsidiary

F. Channel Changes

14248. Do proposed channel changes conflict with recent changes, additions or corrections to the plans?  Yes  No

If yes, explain:______

2. Is material usable for balancing?  Yes  No

3. Waste area. if required

4. Irrigation structures affected by channel changes?  Yes

 No

5. Should Ch.Ch. be fenced inside right-of-way?  Yes

 No

G. Subsurface pipe (Underdrain)

*1.  Recommended  Not

recommended

*a. Location

2. Waste area (Location)

3. Backfill material (Location)

H. Edge drain

*1.  Recommended  Not

recommended

2. Location

ENVIRONMENTAL CONSIDERATIONS

A. Wetlands

25256. Wetland encroachments

25257. Mitigation measures required

25258. Have wetland permit applications been made and approved by the Corps of Engineers?  Yes  No ddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddd ddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddd

Any stipulations or changes required? eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee eeeeeeeeeeeeeeeeeeeeeeeeeeeeee. Have agreements been obtained from the landowner?

A. Additional Corp of Engineer Permits required

25936.  Rivers  Streams

 Drainages

A. Additional permit requirements

26280. DEQ - Air quality permits

26281. DEQ - NPDES permit nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn

Has plan been completed for:

 Roadway  Pit and plan sites ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo ooooooooooooooooooooooooo. Responsibility

 Contractor  WYDOT

A. Archeological

clearances obtained

 Yes

 No

TRAFFIC

A. Detours

*1. Typical section

*2. Design speed

26282. Type of surfacing

26283. Special structures

26284. Method of payment

26285. Detour obliteration:

 Yes

 No nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn

Waste location

26286. Pipe Salvage llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll lllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll. Location mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm

Disposition nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn. Estima ted quantity

B. Traffic will be carried through construction

28032. Temporary guardrail required  Yes

 No

C. Temporary connections

*1. Was survey made?

 Yes  No

*2. Typical section

*3. Design speed

4. Type of surfacing

B. Traffic control:  Yes  No

40. Quantities obtained from Traffic design and field engineer

D. Temporary median cross-overs

*1. Location

*2. Drainage culvert size

E. Intersections or interchanges

*1. Location

*2. Special design

required?

 Yes

 No

3. Special recommendation by field

B. Traffic signals required?  Yes  No

C. Lighting

D. Service roads

*1. Locations (show on plans)

2. Inside of outside right-of-way

*3. Fence location

*4. Design a. Typical section

b. Sub-base:  Yes  No

Depth______

c. Base:  Yes

 No

Depth______

d. Plant mix  Yes  No

Depth______e. To be set up by Materials and Project Development

Excavation (include with balance?)  Yes

 No

Equipment hours

 Bulldozer  Motor Grader  Roller Type ______ Scraper  Truck 

Loader

Compaction

RIGHT-OF-WAY

A. Section ties complete  Yes

 No

A. LUCO and LUFJ complete

 Yes

 No

A. Recommended changes since previous inspection (show on plans)

A. Additional topography (show on plans)

A. Recent ownership changes that would affect design (show on plans)

A. Construction permits

UTILITIES

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXXXXXXX. Recent utility changes (show on plans)

*B. Private utilities to be set up in contract

2432. Location

2433. Contract item

 FA  LS

 Unit

SPECIAL PROVISIONS

Sequence of work, etc

MISCELLANEOUS ITEMS

*A. Historical signs, markers & monuments

3112. Location

3113. Disposition

*B. Turnouts and rest areas -- show on plans and explain

Median cross-overs -- show location on plans and explain

Special design items

*1. Retaining walls

*2. Wells

*3. Sewage systems

*4. Crops involved  Yes

 No

Special precautions  Yes  No

*6. Picnic Facilities

*7. Curb & Gutter

Type  A  B

*8 Double gutter

*9 Sidewalks

*10 Median paving

11. Climbing lanes

28 Issued Apr_ 2008