LEVEL 2 - REVIEW RECORD

Structure Inspection Quality Assurance Program

Review Performed by Region/County for Locals

Wisconsin Department of Transportation

DT2003 1/2007 s.84.17 Wis. Stats.

Date / Agency Under Review
Regional Program Reviewer or County Manager Reviewer

QUALIFICATIONS

Please refer to Section 2.3 of the Wisconsin DOT Structure Inspection Manual for personnel qualification requirements.

Inspection Program Manager - Person in charge of inspection program

Name / WisDOT Inspector Certification Number
Registered Professional Engineer / Program Manager
Yes / No / Yes / No
Time Allocation (%)
Bridge/Culvert Inspection / Other Bridge Related Activities / Non-Bridge Activities

Inspection Team Leader(s) - People who conduct inspections and sign inspection reports

Name / WisDOT Inspector(s) Certification Number
Registered Professional Engineer
Yes / No
Time Allocation (%)
Bridge/Culvert Inspection / Other Bridge Related Activities / Non-Bridge Activities

RECORD KEEPING

Bridge File

Location of Bridge File
File Accessible to Users
Yes / No – Comments:
Bridges Sorted in the File by
Bridge Number / Road / Township / Other:
Separate Lists of Bridges Requiring the Following Inspection Types
Fracture Critical / Diving / Other Special Inspections:
Length of Time Information is Kept in the File

Bridge Inspection Reports

Bridge Inspection Reports Are Reviewed for Accuracy and Completeness
Yes / No – Reviewer:

INSPECTION

Planning and Scheduling

Number of Bridges the Program is Responsible to Inspect / Number of Inspections Performed in Past Calendar Year
Bridge Plans Available in Office If Needed
Yes / No – Comments:

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INSPECTION - continued

Initial Inspections – New Structures
Baseline Assessment Performed and Problems Identified / Load Rating Performed and Calculations on File
Yes / No - Comments: / Yes / No
Inventory Update Inspections - Rehabilitated Structure
Bridge Inspection Report Form Updated to Reflect Modifications to Structure / New Load Rating Performed
Yes / No - Comments: / Yes / No
SI&A Information Updated / Fracture Critical Members Located and Recorded
Yes / No - Comments: / Yes / No
Routine Inspections
List Frequency for Routine Inspections
All Inspections Performed in One Year or Split Between Years
Yes / No - Comments:
Damage Inspections
Damage Inspections Performed
Yes / No - Comments:
Load Posted / Closed Bridges
Number of Load Posted Bridges / Number of Closed Bridges
Comments
In-Depth Inspections
Number of Redundant Bridges with Unique Features that May Require an In-Depth Inspection
Pin & Hanger / Pin Through Web / Truss & Girder Bridges with Floor Beams & Stringers
Moveable / Other:
Comments
Fracture Critical Inspections
Number of Fracture Critical Bridges the Program is Responsible to Inspect
List Inspection Frequency
Underwater Inspections
Number of Bridges that are over Water / Number of Bridges that are Scour Critical / Action Plans Implemented
Yes / No
Number of Bridges that Require Underwater Inspection by Visual/ Probe
- Frequency: / Number of Bridges that Require Underwater Inspection by Diving
- Frequency:
Interim Inspections
Who Determines what Bridges Require an Interim Inspection?
- Comments:
Number of Bridges that Currently Require Interim Inspections / Number of Load Posted
Number of Scour Critical / Other
Moveable Structure Inspections
Number of Movable Bridges the Program is Responsible for Inspecting
- Frequency:
Who conducts Structural, Mechanical, Electrical and Hydraulic Inspection?

SAFETY

Personal Safety
Inspections Regularly Performed by a Team of Two or More Inspectors
Yes / No - Comments:
Is Adequate Safety Equipment Available to you for use in Inspection Work?
Yes / No - Comments:
Public Safety
Work zone protection should be in accordance with the “Manual of Uniform Traffic Control Devices.” Describe how traffic control is set up for bridge inspection.

Follow-Up Actions

Inspectors Recommend Maintenance Actions on Inspection Form
Yes / No
Recommendations Made by Inspector are Reviewed by Maintaining Authority
Yes / No - Reviewer:
What procedure is used to follow-up and track maintenance actions?
Are completed repairs noted in bridge file?
Yes / No

FIELD REVIEW

The field review is intended to look at a minimum of two bridges (typically bridges with problems); bridges that are in the replacement program; bridges with special features; bridges of local interest or questions; or load posted bridges.

List bridges along with reasons for selection

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Bridge Replacement

Taking Advantage of all Bridge Replacement Funds Available
Yes / No

Describe how bridge replacements are prioritized.

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SUMMARY OF LEVEL 2 REVIEW COMMENTS

Reviewer’s Comments

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Reviewer’s Confidence Level / Good / Poor
5 / 4 / 3 / 2 / 1
(Regional Program Reviewer or County Manager Reviewer Signature) / (Date)
(Reviewed Agency’s Inspection Program Manager Signature) / (Date)

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