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SAN JOAQUIN COUNTY BRIDGE INSPECTION FORM <br />ROAD NAME: /I � BIR GE #: ola& 2ZI� <br />; <br />INSPECTION DATE. 71 � 5 BRIDGE TYPE: 71i0, Gr- <br />INSPECTOR 1: j �( INSPECTOR 2. <br />❑ POA Bridge <br />11. APPROACH ROADWAY ❑ N/A Type*!� <br />No Significant Defects ❑ Pavement Rutting @ <br />Cracks @ <br />Pavement Subsidence @ <br />R marks: PAV�y, <br />12. APPROACH GUARD RAILING ❑ N/A Type: � Q(� <br />No Significant Defects U Missing "P" Markers @ <br />Damage @ <br />Remarks: <br />13. BRIDGE RAILING ❑ N/A Type: (�/�4(� �� <br />No Significant Defects ❑ Dry Rot @ <br />Damage @ Nor k 14 <br />Debris@ <br />Remarks: <br />Type: <br />has S412ifd ci "MAF <br />Type: <br />Type: � �ra�son <br />❑ Graffiti@ <br />14. SN,IPERSTRUCTURE ❑ N/A Type: �i�✓ <br />No Significant Defects Lj Drain Clogged: ❑ Debris ❑ Vegetation ❑ Other: <br />_Surface ❑ N/A Type: <br />No Significant Defects ❑ Deck Overlay Prevents Proper Visual Inspection <br />Cracks @ Type: <br />Scaling @ <br />Spalling @ <br />Remarks: h �g�_ <br />Soffit ❑ N/A Type: ��,N <br />No Significant Defects Spalling @ <br />Cracks @ <br />Rebar Exposure @ <br />Timber Plank Decay @ o asS <br />Section <br />Loss <br />Remarks: <br />Superstructure Other Than Deck ❑ N/A <br />No Significant Defects ❑Cracks @ <br />Timber Stringer Decay @ <br />❑ <br />Section Loss @ Spalling @ <br />Bearing Damage @ <br />Section Loss @ <br />Remarks: <br />❑ Light ❑Medium <br />❑Heavy <br />Rebar Delamination @ <br />ralsia, - M lass <br />Type: <br />Type: <br />w►i /�o✓ <br />❑ Moisture ❑Mold/Fungus <br />Depth: <br />Type: Tir�p' S{n N� <br />Type: <br />Due to: ❑ Moisture ❑ Mold/Fungus <br />Depth: <br />U Damaged Stringer @ <br />Due to: �❑ Moisture ❑ Mold/Fungus <br />Depth: <br />s/is/zoi4 Page 1 <br />