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U. S. DOT CROSSING INVENTORY FORM <br />A. Revision Date (MM/DD/YYYY) <br />PAGE 2 <br />D. Crossing Inventory Number (7 char.) <br />03/2020 <br />Part III: Highway or Pathway Traffic Control Device Information <br />1. Are there 2. Types of Passive Traffic Control Devices associated with the Crossing <br />Signs or Signals? 2A Crossbuck <br />2.B. STOP Signs (R1-1) <br />2.C. YIELD Signs (R1-2) <br />2.D. Advance Warning Signs (Check allthat apply, include count) El None <br />Assemblies (count) <br />(count) <br />(count) <br />® W10-1 2 ❑ W10-3 ❑ W10-11 <br />©yes ❑ No <br />0 <br />0 <br />❑ W10-2 ❑ W10-4 ❑ W10-12 <br />2.E. Low Ground Clearance Sign <br />2.F. Pavement Markings <br />2.G. Channelization <br />2.H. EXEMPT Sign <br />2.1. ENS Sign (1-13) <br />(W10-5) <br />Devices/Medians <br />(R15-3) <br />Displayed <br />El Yes (count___) <br />©Stop Lines ❑Dynamic Envelope <br />®All Approaches ®Median <br />El Yes <br />I'd Yes <br />D No <br />D RR Xing Symbols ❑ None <br />❑ One Approach ❑ None <br />®No <br />❑ No <br />2.1. Other MUTCD Signs El Yes ©No <br />2.K. Private Crossing <br />21. LED Enhanced Signs (List types) <br />Signs (if private) <br />Specify Type Count <br />Specify Type Count —El <br />Yes ElNo <br />Specify Type Count _ <br />3. Types of Train Activated Warning Devices atthe Grade Crossing (specify count of each device for all that apply) <br />3.A. Gate Arms <br />3.B. Gate Configuration <br />3.C. Cantilevered (or Bridged) Flashing Light <br />3.D. Mast Mounted Flashing Lights <br />3.E. Total Count of <br />(count) <br />Structures (count) <br />(count of masts) 2 <br />Flashing Light Pairs <br />® 2 Quad ❑ Full (Barrier) <br />Over Traffic Lane 0 ❑ Incandescent <br />❑ Incandescent ® LED <br />Roadway 2 <br />❑ 3 Quad Resistance <br />I'd Back Lights Included ❑ Side Lights <br />4 <br />Pedestrian <br />❑ 4 Quad ❑ Median Gates <br />Not Over Traffic Lane 0 ❑ LED <br />Included <br />3.F. Installation Date of Current <br />3.G. Wayside Horn <br />3.H. Highway Traffic Signals Controlling <br />3.1. Bells <br />Active Warning Devices: (MM/yYYY) <br />Crossing <br />(count) <br />11 2019 ❑ Not Required <br />❑ yes Installed on (MM/YYYY) <br />❑ yes Ed No <br />1 <br />© No <br />3.1. Non -Train Active Warning <br />3.K. Other Flashing Lights or Warning Devices <br />❑ Flagging/Flagman ❑Manually Operated Signals ❑ Watchman ❑ Floodlighting ❑ None <br />Count 0 Specify type <br />4.A. Does nearby Hwy <br />4.B. Hwy Traffic Signal <br />4.C. Hwy Traffic Signal Preemption <br />5. High way Traffic Pre -Signals <br />6. Highway Monitoring Devices <br />Intersection have <br />Interconnection <br />El Yes ElNo <br />(Check all that apply) <br />Traffic Signa Is? <br />© Not Interconnected <br />❑ yes- Photo/Video Recording <br />❑ For Traffic Signals <br />❑ Simultaneous <br />Storage Distance <br />❑ yes— Vehicle Presence Detection <br />❑ yes © No <br />❑ For Warning Signs <br />❑ Advance <br />Stop Line Distance' <br />Ed None <br />Part IV: Physical Characteristics <br />1. Traffic Lanes Crossing Railroad ❑ One-way Traffic <br />2. Is Roadway/Pathway <br />3. Does Track Run Down a Street? <br />4. Is Crossing Illuminated? (Street <br />❑ Two-way Traffic <br />Paved? <br />lights within approx. 50 feet from <br />Number of Lanes 2 D Divided Traffic <br />®Yes ❑ No <br />❑ yes ® No <br />nearest roil) ❑ yes ® No <br />5. Crossing Surface (on Main Track, multiple types allowed) Installation Date' (MM/YYYY) 05 1998 —Width* 10 Length' 48 <br />El1 Timber El2 Asphalt El3 Asphalt and Timber © 4 Concrete El5 Concrete and Rubber El6 Rubber ❑ 7 Metal <br />❑ 8 Unconsolidated ❑ 9 Composite ❑ 10 Other(specify) <br />6. Intersecting Roadway within 500feet? <br />7. Smallest Crossing Angle <br />8. Is Commercial Power Available?' <br />❑ yes D No If yes, Approximate Distance(feet) <br />❑ 0°-29° ❑ 300-59° ® 60°-90° <br />©yes El No <br />Part V: Public Highway Information <br />1. Highway System <br />2. Functional Classification of Road at Crossing <br />3. Is Crossing on State Highway <br />4. Highway Speed Limit <br />❑ (0) Rural ® (1) Urban <br />System? <br />30 MPH <br />❑ (01) Interstate Highway System <br />❑ (1) Interstate ❑ (5) Major Collector <br />❑ yes Ed No <br />® Posted ❑ Statutory <br />❑ (02) Other Nat Hwy System (NHS) <br />❑ (2) Other Freeways and Expressways <br />5. Linear Referencing System (LRS Route 1D) " <br />❑ (03) Federal AID, Not NHS <br />❑ (3) Other Principal Arterial ❑ (6) Minor Collector <br />6. LRS Milepost " <br />D (08) Non -Federal Aid <br />❑ (4) MinorArterial ® (7) Local <br />7. Annual Average Daily Traffic(AADT) <br />8. Estimated Percent Trucks <br />9. Regularly Used by School Buses? <br />10. Emergency Services Route <br />Year 2011 AADT 002860 3450 <br />10 % <br />❑yes I'd No Average Numberper Day <br />❑yes El No <br />Submission Information -This information is used for administrative purposes and is not available on the public website. <br />Submitted by Organization Phone _ Date _ <br />Public reporting burden forthis information collection is estimated to average 30 minutes per response, includingthe time for reviewing instructions, searching existing data <br />sources, gathering and maintainingthe data needed and completing and reviewing the collection of information. Accordingtothe Paperwork Reduction Act of 1995, a federal <br />agency may not conduct or sponsor, and a person is not required to, norshall a person be subject to a penalty forfailure to comply with, a collection of information unless it <br />displays a currentlyvalid OMB control number. The valid OMB control numberfor information collection is 2130-0017. Send comments regardingthis burden estimate or any <br />other aspect of this collection, including for reducing this burden to: Information Collection Officer, Federal Railroad Administration, 1200 New Jersey Ave. SE, MS -25 <br />Washington, DC 20590. <br />FORM FRA F 6180.71 (Rev. 08/03/2016) OMB approval expires 11/30/2022 Page 2 OF 2 <br />