Shims) DECK Nails Curbs and Blocks Hand Rails Deck to Girder Bolts Hardware Delineators Girders / Slabs SUPERSTRUCTURE Diaphragms SPAN Trussing Bracing Hardware Caps Piles or Posts Concrete PIERS Bracing or Sheathing Cribs Hardware Riprap Overall Cribs Tie-backs Bin Walls Caps or Sills Piles or Posts Concrete ABUTMENTS Bulkhead Planks Wing Wall Planks Bracing Hardware Fill Riprap Overall APPROACHES PRESENT WATER LEVEL m PRESENT WATER CLEARANCE m ESTIMATED HIGH-WATER LEVEL HAZARD(S) DESCRIPTION m HAZARDS: rHigh water Debris Scour REPAIR REQUIRED Yes No PROFESSIONAL INSPECTION REQUIRED Yes No AS-BUILT CHECKED Yes No NUMBER OF PICTURES TAKEN Ice None REPAIR DESCRIPTION AND COST ESTIMATE NARROW STRUCTURE SIGNS Yes PRESENT POSTED RATING tonnes No SUGGESTED REPLACEMENT DATE at new load rating: at original COMMENTS NEW LOAD RATING INSPECTOR S SIGNATURE YYYY - MM - DD FS 1052C HTH 2008/03 DISTRIBUTION: REVIEWED AND NOTED BY (SIGNATURE) tonnes WHITE — Region CANARY — District DATE SIGNED P.Eng..
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