Assessment Narrative Evaluation Sample

Final Drive Route Assessment Narrative (DMV - TSD Minimum Maneuvers)

Evaluation Worksheet for __SAMPLE SCHOOL__

Provider / School

Route ID: “Evans Locale” Don’t put your school name in here (it’s above)… Put what you call the location for this route.
(Location, etc.)
Date Submitted: 2-3-15
(TSD Use Only) / □ In Process ■ Final / Approval Date: 2-11-15

*Note: One worksheet (narrative) must be submitted for each route seeking approval. Shaded areas are for TSD Use Only.

Maneuver / Reference
(Tell where the maneuver is on the route) / Acceptable = √
(If no √ then =>) / Recommendation
(TSD Use Only) ç======
Turn – Left (1) / S Elm Street & SW 2nd Avenue / √ / For these 10 boxes, all we need is the “street and street” declaration. We have shown some samples in the “Reference” column.
Turns in or out of parking lots do not count.
Intersection controls can be signals or signs.
Turn – Left (2) / 99E @ light & S Elm Street / √
Turn – Left (3) / NW 3rd Avenue & N Holly Street / √
Turn – Right (1) / SW 2nd Avenue & Turner Drive / √
Turn – Right (2) / 99E & Barlow Road / √
Turn – Right (3) / S Knights Bridge Road &
S. Arndt Road / √
Intersection – Uncontrolled / Barlow & Arndt Road / √
Intersection – Controlled (1) / Elm and 99E (Signal) / √
Intersection – Controlled (2) / Ivy & 99E (4-Way Stop) / √
Intersection – Straight / 99E & S. Berg Road / √
Speed Zone – Posted (1) / Barlow Road (35 mph in town, then 45mph out of town) / √ / List where and what the actual speed is for each zone
Speed Zone – Posted (2) / S. Arndt Road (45 mph) / √
Speed Zone – Unposted / S. Knights Bridge [25 mph in town] / √
Lane Configuration (1) / 99E = 4 lane Hwy / √ / 2 lanes? 4 lanes? Divided with median? Two different configurations needed.
Lane Configuration (2) / S. Arndt R. = 2 lane / √
Lane Change - Left / 99E Hwy / √
Lane Change – Right / 99E Hwy / √
Parking / NW 3rd Avenue (Forward Angle Park) / √ / Parallel?
Forward Angle? Perpendicular Backing?
Parking – Un-park / NW 3rd Avenue (Back out – Angle Park) / √
Backing / NW 4th Avenue (Pull to curb, back 2 car lengths) / √ / Straight backing?
An additional parking maneuver?
Backing – Re-enter / NW 4th Avenue (Enter Traffic from curb) / √
Signature of Submitter: Iwanna Dogoode / Date: 2-3-15
Signature of Reviewer: Bill Warner
(TSD Use Only) / Date: 2-3-15, 2-11-15

FD Assessment Narrative Evaluation SAMPLE.docx – Worksheet Revised September 2017 Page 2