� /'v la /2-[_ I I DA!'No. !RBS lLACO U.S. Department of Transportation I I · L�l�L�J - �

Federal Highway Administration- Shi:ct# 1 of fed era! Project # EO ER - ( ) California Division-- Title 23 Dtas!t:r No. CA 2 PR ER -Damage Assessment Form (DAF) [ 1 I I - □ ( )

Tvre ofReoair EO· AGE!ICY FORCES CT WDl"I,:. Ordcrf(s�------

EA(s): __________ _

Descrin..!iJ>n ofWork Design and mplemenl detm.r for the Paramount Boulevard closi.re. (X210000441) Evaluation of roadway lo detecmine pavement degradation due ta the increased traffic (X210000449).

EQ. CONTRACT

EO EA(s): Contracr with Shertffs for detour enforcement

(X210000440) and Newspapers for adve,tising the ----------+ detour.

Cost Summarv PE 18,000

CE 9.000

Constnrtion 18,000

PE

CE

Construction 22.000

NOTE: Environmental doeumfflllllion filr EO i, req uircd. [I is generally slarlcd after work bas begun. R/W 0

I SublCUI !:mer gen �y Open iDg PR- CONSTRUCTION

� ,::: ] ·i LO Conb'act D FA � e 8 C: -� �, PREAs

FA 1cqui1es an approved Pff

NOTE:l'RlOR AUfHORJZATION (APf>ROVED E-76) 1S "REQUIRED TO PROCEED WITH PEltMANENT RESTORATION "R/W & CONSTRUCTION

PE

CE

Construction

R,W

$67,000

Applicant Count) lnciden\ Date (mmlddlyyyy) lnsp,ection Los Angeles County DPW I Los Angeles 12/14/2011 I V1 I /"v/1,0fz,

Federal-aid Hi!_!:h\wy? Location of DJ1magc; Per Site l{_J or LJ Per Mk I Nam� ofRoad/Bridgc: Paramount Boulevard over State Roule 60 Y for )CS, ifnu, ineligible for ER lunds iYl

PM Begin: R007.77 PM Length: Map No I 13 V 25 I (in �ct) PM End: R007.77 functional Classification Type:

Road/Bridge Data:

Traveled Way:

Shoulder:

Bridge Nu

Width

Width

531910

Type:

Type:

Type:

PCC B PCC

AC

AC B Gravel GraVl!I 0th er Principal .Alteri al

Route N -Forest Hwy? YIN □

Existirg ADT: -·

lnte1state? YIN L

Description The Paramount Boulevard bridge over S R-60 failed due la s lanker lire that occurred an the Freeway below. The of. resulting fa�ure required that the County implement a detour 10 direct people around the closure.

Damage:

COST ES1lMAlE

NOTE: Env i ronmcn la) cleara n te for perrnancn I r�toralion is Subtotal Pcnnancnl Restontu� $0 conducted lhrnu�h nonnal "Federal-a id oro�cdures

Eligible

�a Yes L � -� Yes L: LJ Yes LJ�

Signature Dale I Local ll#S!J,'Yif app� . / / .... � �---- "/// //Z....

. ' .

PE Total

CE Total

RJWTotal

Cone1ruction 1·a1ai

$16,000

$9,000

$0

$40,000

TOTAL F.STLMATE $67,000

Agency sig. Name (prinl): �� /21�r.; ,->:7_f .;l ') FHWA Sig. Namc(print): CTasig:11ature N� (printi ,J bkPI) :5 A,/2..M l'&f:/:@ DAF Prepared by (print): Original; Caltrum Piit.ict Copi•3: FBWA, Division of Local Assi,;lanc.c(local rMd,;), F•den,\ Rc.�ources (�tate hv.,Y).IIQ Major Damagefn�ineer(:s1Jltc hwy) •Wrl� �NIA" in FHW A signature blcck if theprojeetbn no Fodera\ ER funding or federal ER fonding delegated to the Stale. FHWA Sig11a111re REQUTRF.D (ot; all Fed•ral Funded Sl;ll\' prniects REQUIRED for 1111)1 . J a;a) AfM9' Pooiaas with I) a11y 8.ETTERMENT, 2) more lhan 2 ROW takes or 3) wh•npav,ng ism

----- ---------

0 DAF # RBS - LAGO - 0 0 1 -

U.S. Depmtmenl ofTransportation Sheet# 2 of F cde raJ H Lghway Administration Applicant

Califi:lmia Division- Title 23 Los Angeles County DPW Damage A�scssment Form (OAF)

Agency-EO Cale I✓ I EO contractT T- PR Cale □_

Unit Price Labor, Materials, and E_guioment Unit* Quantitv* 10,000.00 Newspaper Advertis ng LS 1 i 12,000.00 Traffic Control (LA County Sheriff's) LS 1

359.29 Fabricate and install signs 29 EA

7,048.87 Update Signal timing LS 1

Total

* Lump Sum wi!I general!y only be accep1ed for non biddable items, such as Mobilization.

J ustifications!t.:ommcnts: Non-typical Scope, PE/CE Cost Engineering estimates etc.

Cost 10,000.00

12,000.00

10,419.41

7,048.87

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

39,468.28

FlIWA CA Form (CA Rev 12/08/09)

https://39,468.28https://7,048.87https://10,419.41https://12,000.00https://10,000.00https://7,048.87https://12,000.00https://10,000.00https://39,468.28https://7,048.87https://7,048.87https://10,419.41https://12,000.00https://12,000.00https://10,000.00https://10,000.00

-----

------

DAF # RBS - LAGO

U.S. Department of Transportation Sheet# of Federal Highway Administration Applicant

California Division-Title 23 ECELV�� Damage Assessment Fann (OAF)

Photos. Sketches and/or Narrative

BY: --------Paramount Blvd at Bradbury Dive Looking South

l>i 10 t o d . escnp 1. ,on:

FHWA CAForn1 (CA Rev 12/08!09)

-----DAf # RBS _ LAGO U.S. Department of Transportation Sheet# of Federal Highway Administration

Applicant California Division- Title 23

Damage Assessment Form (OAF)

Photos, Sketches and/or Narrative

Paramount Blvd at Bradbury Dive Looking South Ph o o t d escnp . 1. 10n:

FHWA CA Fnm1 (CA Rev 12/0&/09}

OAF# RBS - LAGO - 0 0 1 _ 0 U.S. Department of Transportation Sheet# of Federal Highway Administration

Applicant Califomia Division- Title 23

Damage Assessment Form (OAF)

Photos, Sketches and/or Narrative

Paramount Blvd at Bradbury Dive Looking South I)h o t o d . escnp 1. 10n:

FHWA CA Form (CA Rev 12/08/09)

c,""1,1c0ro,, ""

PARAMOUNT BOULEVARD 0"

I MORA

o,;1X ST .2.00 .�

IGffi:_ ST_ _ .;

fRWY

99 GAMPO� VIA

s�

_,,"'!" SAEV�--·

• SAN __ ,_ CARLO __ ,.

;i,AN __ (?_EJ.-!'_�RO

100

.. ..

sr "" , __

AV &

.,:

l\'y

" ..

DEPARTMENT OF PUBLIC WORKS

900 S. FremontAve.

Alhambra, CA 91803

TRAFFIC & LIGHTING DIVISION

DESIGN SECTION

Data contained in this m"-' is prodl.lOed il"I whole or part il�m the L, Covnt)' Department of Public Wort

1i = � c, . . OAAr

r-· I I I I I I I

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COUNTY C I I I

I

DEPARTMENT I I I I I I I I I I I I I I I I I I I I I I I I I I I > I

LOS ANGELES

OF PUBLIC WORKS

SJGN LEGEND

LINCOLN AV

LOS ANGELES COUNTY DEPARTMENT OF PUBLIC WORKS

TRAFFIC AND LIGHTINC DIVISION

TRAi-!="1C DtTOLJR PLAN

PARAMOUNT BLVD AT POMONA FWY

0 > -' a:,

W2� ...I

w !,:'._o5 4V""°'' ffi

!t

@

HUSH ST

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::::::v-

Federal Aid Data System Page 1 of2

FridaY. Jung 15. 2012 HELP !Rev 112012) You are logged in as: Federal Aid Data System 5127512 REYNALDO SARMIENTO

Project Request OAF Reports User Proli!e Ad minis tr a ti on Log Off Home

Listing ofRevisionsforTllis DAF Selecl EdoI.to update tne OAF belOw. Selecl Delete todelele lhe OAF. Select Create Rev9(/� lo create a revison for lh,o OAF. i 1o

Report No: RBS-LACO .w1 Disaster No: CA2012.1 County: 037 - LA

Rev No Crea led By Create Date Last Updated By Update Date

Edi\ Del�t� 0 SARMIENTO. REYNALDO 06/15/2012 SARMIENTO, REYNALDO 00115/2012 Cr�_aJ.�B.ev[?on io

DAF Slalus I Report No: RBS- lACO - 001--0 Disaster No: CA2012-1 County: 037 • LA lnci den I Date: 11211412011 ! ii!il mmtddlyyy y Inspect Date: 1osr1212012 lttiii

Responsibl" A9encY: District: ! o7 Admin: j LOCAL

·oApplicant: ILOS ANGELES CO DEPT OF PUBLIC WO�

Road/Bridge ---------�� Per Sile o.r Per Begin End Total ___ · _ PM JJ7 ] PM:e� Feet: c:o. oo o_ __.olla1ne. ii'PRAM9UN1' BL OVER STATE ROUI,E 60/ Mile: f PEf.< SU :::J c:.::.... l I

Federal Aid H111'l': Ci Yes r No Map No: ,�V25 j Brodge No: 1531910 I Type; I io lie Forest Hwy System: r Yes Ci No Stale/Local Rle No: c=:J Traveled Way Widlh: i Type: [ Sele Cl one ;;:t• ;:=:::=:� I

Shoulder Width: L _o _ �I Type: Js.iectono:±1 lnterstatl3: ('"' Yes 10' No AOT {Existing): L__j _o

Damage Des.,-iption lat mos1o4CI0 characters): ITRoP"ARAMOUNT BL BRIDGE OVER SR.SO FAILED DUE TOA TANKER FIRE THAT OCCURRED ONT HE FREEWAY BELOW THE RE SUL TING FAILURE ;if 4 iREQUIRED THAT THE COUNTY IMPLEMENT A DE"l"OUR TO DIRECT THE PEOPLE AROUND THE CLOSURE.

l ________________________________________ �J....,'i:i!

COST ESTIMATE

Cosl Summary Erne r aeacv OP 1nin g Asienc x Farces Desciiption of Work PE: L 18,JlG0.OOj

DESIGNED & IMPLEMENTED DETOUR FOR THE PARAMOUNT BL CLOSURE .'-'-I EVALUATION OF ROADWAY TO DETERMINE PAVEMENT DEGRADATION DUE TO THE '""'."\

,...:,f Sf'N/Conlract No:eeL _o _ [ !INCRE.ASED TRAFFIC ___;;18.00o::.:,: '-' CON:o .::!JOi c:.: ··o :.;0o

CTWorkOrderNo: 1:l.� ----'o ... 8Le ��Je�..,,,J 3: _L __.e_o '- - ------'I 5: le ee ---e lee .. �o je2:oi., eo __ �e_] 4, 1 o---ee

EmeIQ!'Il,£Y..Q�!!l!!9.G..!tnl.@£! Descripllon of Work CONTRACTED WITI-1o11-IE SHERIFF FOR DETOUR ENFORCEMENT t NEWSPAPERS IFOR ADVERTISING THE DETOUR.

coN: �I ====22=�=00=.oo�I ! ·SPN/Conlracl No: IX210000440 ee RfW· i oooo

loSlblotal Emergency Opening:

Cost Summary

PE: i Description of Work I ;:::===;

CE: ; Contract Type: ) Solecl

nmtddlyyyy

nm/ddlyyyy

Federal Aid Data System Page 2 of2

Eli91b e Last NBflle First Name Osle l le Ye� r No r NIA Local Agency: iABRAMSON _ _j. !ALLAN i06 ,,112012 1 iil

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