Limited Scope Sign Structure Checklist

Concept Development Checklist
Sign Structure Replacement Project
Contract Number:
Structure Number(s):
Milepost
UPC Number:
Municipality(ies):
County:
Project Manager:
CD Designer:
Notes:
 All item checked “Y” or “N” shall be briefly discussed in the ‘Comments’ section below the
checklist items.

NFI: Needs Further Investigation in Final Design (explain below).
Concept Development Checklist
A. Structural Scope Of Work
Y
N
N/A
NFI
1. Is the sign structure currently in service? (Provide any
additional information in the ‘Comments’ section
below.)
2. Is the sign structure ‘bridge mounted’, ‘on pier’ or ‘on
special structure’? (Provide any additional information
in the ‘Comments’ section below.)
3. Does the sign structure have a triangular truss (trichord)? (Provide any additional information in the
‘Comments’ section below.)
4. Does the sign structure consist of aluminum truss
and/or aluminum posts? (Provide any additional
information in the ‘Comments’ section below.)
5. Has the sign structure developed cracks in any
members? (Provide any additional information in the
‘Comments’ section below.)
Released: 08/2013
6.
Will the sign structure require a caisson/drilled shaft
foundation in order to avoid ROW or utility conflicts?
(Provide any additional information in the ‘Comments’
section below.)
7. Will sign structure replacement require new soil
borings? (Provide any additional information in the
‘Comments’ section below.)
Comments:
1.
2.
3.
4.
5.
6.
7.
B. Roadway Design Scope of Work
Y
N
N/A
NFI
1. Will sign structure replacement require curb and/or
sidewalk replacement? (Provide any additional
information in the ‘Comments’ section below.)
2. Is there existing guide rail within the project limits?
3. If there is existing guide rail within the project limits,
does it meet current design standards?
4. Is there existing lighting within the project limits?
5. Is there existing fencing within the project limits?
6. Will there be any temporary or permanent ROW
impacts (e.g., acquisition, easement)? (List below in the
‘Comments’ section a detailed description of the
location and purpose of the impacts.)
Comments:
1.
2.
3.
4.
5.
6.
Released: 08/2013
C. Traffic Management (Operations) Recommendations
Y
N
N/A
NFI
1. Staged Construction - Is it necessary and/or feasible?
Has conceptual approval been received from Traffic
Operations? (Provide any additional information in the
‘Comments’ section below.)
2. Detour – Is it necessary and/or feasible? Has conceptual
approval been received from Traffic Operations?
(Provide any additional information in the ‘Comments’
section below.)
3. Have feasible Lane Closure Hours been obtained from
Traffic Operations? (Attach Traffic Operations
correspondence to this Checklist and provide any
additional information in the ‘Comments’ section
below.)
Comments:
1.
2.
3.
D. Traffic Engineering
Y
N
N/A
NFI
1. Does this sign structure require illumination? (Provide
any additional information in the ‘Comments’ section
below.)
2. Does this sign structure require reflective panels?
(Provide any additional information in the ‘Comments’
section below.)
3. Do any of the sign panels need revisions to meet the
current standards? (Provide any additional information
in the ‘Comments’ section below.)
Comments:
1.
2.
3.
Released: 08/2013
E. Utility Facilities
Y
N
N/A
NFI
1. Are there aerial facilities within the project limits?
(Provide a list of identified Aerial Facilities in the
‘Comments’ section below. Also, attach photos of
existing facilities to this Checklist.)
2. Are there any underground utilities? (Provide a list of
identified underground facilities in the ‘Comments’
section below.)
3. Are there any potential conflicts with aerial or
underground utilities? (Provide any additional
information in the ‘Comments’ section below.)
4. Are test pit locations needed to provide assurance of
avoiding conflict? (Provide any additional information in
the ‘Comments’ section below.)
Comments:
1.
2.
3.
4.
F. ITS
Y
N
N/A
NFI
1. Are there existing ITS facilities within the project limits?
(Provide any additional information in the ‘Comments’
section below.)
Comments:
1.
G. Environmental Impacts / Concerns – Attach a copy of the Environmental Screening Report (ESR)
which will identify and document potential environmental issues. The ERS is to be prepared by the
Bureau of Landscape Architecture and Environmental Solutions (BLAES).
Y
N
N/A
NFI
1. Is there a potential for wetland impacts as a result of
the proposed work? (If yes, list potential impacts in the
‘Comments’ section below.)
2. Is there a potential for hazardous waste impacts as a
result of the proposed work? (If yes, list potential
impacts in the ‘Comments’ section below.)
Released: 08/2013
3. Is there a potential need for other permits as a result of
the proposed work? (If yes, list potential permits in the
‘Comments’ section below.)
Comments:
1.
2.
3.
H. Offices / SME’s consulted on this Project
Y
N
Office
Name / Phone #
1. Structures
2. ITS
3. Traffic Engineering
4. Traffic Operations
5. Construction Management
(Constructability Review)
6. Environmental
7. Project Management
8. Roadway Design
I. Funding / Authorization Information
Y
N
1. Is the Project Programmed in the STIP for all Phases of
Work? Please provide Line Item info below.
2. What is the anticipated FD authorization date and
estimate? Provide info below.
3. What is the anticipated CON authorization date and
estimate? Provide info below.
Comments:
1.
2.
3.
Released: 08/2013
J. Project Management
Y
N
N/A
NFI
1. Is the sign structure part of any other CPM Project?
(Provide any additional information in the ‘Comments’
section below)
2. Is there any project in the vicinity of this sign structure?
(If yes, note in the ‘Comments’ section below if this sign
structure can be replaced as part of that project?)
Comments:
1.
2.
K. Verification of Limited Scope Project Development
Y
N
Based on the information obtained/observed during the field visit, input obtained
from SME’s, and coordination/cross-checks with the various Management Systems,
does the proposed scope of work for this project fit the definition of a ‘Limited
Scope Project’.
Approved:
(Insert Name), Project Manager
Date
Released: 08/2013