1451 non-frangible light standard installation inspection ...1451 (02/19) non-frangible light...
TRANSCRIPT
Michigan Department of Transportation
1451 (02/19)
NON-FRANGIBLE LIGHT STANDARD INSTALLATION INSPECTION REPORT
To be completed in conjunction with Non-Frangible Light Standard Installation Inspection Procedure and submitted to the Structural Fabrication Unit.
File Naming Convention: 1451 SM-CS-JN Date.pdf
PAGE 1 OF 1
GENERAL INFORMATION
STATION MARK CONTROL SECTION JOB NUMBER DATE
REGION COUNTY ROUTE
LOCATION DESCRIPTION
GPS LAT
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GPS LONG
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STRUCTURE INFORMATION
ARM TYPE SINGLE
DOUBLE
NUMBER OF ARMS ARM TO UPRIGHT CONNECTIONS WELDS
BOLTS
UPRIGHT LEAN COATING GALVANIZED PAINTED ALUMINUM
STRUCTURE BASE & FOUNDATION INSPECTION
WELDS
FOUNDATION
ANCHOR BOLT ID# ANCHOR BOLT DIAMETER BOLT CIRCLE DIAMETER (BC)
ANCHOR BOLT INSPECTION
SOUNDING ANCHOR NUTS
1 2 3 4
ANCHOR BOLT PROJECTION (P)
1 2 3 4
STAND-OFF DISTANCE (S)
1 2 3 4
ULTRASONIC TESTING
1 2 3 4
REMARKS
INSPECTOR COMPANY