City/ Town: _______________________________________________________
Route:
_______________________________________________________
Intersection Name; Street Names:
_______________________________________________________
RAMP AND LEVEL LANDING
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Wheel
Wheel
Wheel
Wheel
chair
chair
chair
chair
ramp #1 ramp #2 ramp #3 ramp #4
1 Identify Ramp Type (From
Sketches – If not identifiable,
sketch Ramp.)
2 Is vertical curb blocking path of
travel (Y/N) If Yes stop here.
(Cross walk to a vertical curb OR
is access to a curb cut on the
opposite side of the street
blocked by in-place curb)
3 Is Ramp Opening Perpendicular
to Curb AND Grade Break Lines
Across Path of Travel (Y/N)
4 Is Ramp opening Within Cross
Walk (Y/N)
5 Tactile/Detectable Warning Panel
in place (Y/N)
6 Ramp Opening WIDTH at Gutter
6 Change in Level Roadway to
a Ramp Code A, B, or C. (A Less
than ¼ - B From ¼ to ½ inch with
bevel - C Greater than ¼ inch
without bevel or greater than ½
inch)
6 Evidence of Ponding on Ramp or
b at Gutter (Y/N)
7 Gutter Slope Parallel to Sidewalk
in Percent
8 Slope of street to gutter
perpendicular to the gutter line
9 Ramp Slope in % Level Landing
to Street (Measure and Record at
6” from left side; center; 6” from
right edge.)
1 Ramp Cross Slope in % at
0 center.
Save: 2013-May-01
C:\Users\brooksj\Desktop\Workspace\ADA CivilRights\From Michelle\Attachment 10a Curb Ramp Inventory Data sheet.doc
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Wheel
Wheel
Wheel
Wheel
chair
chair
chair
chair
ramp #1 ramp #2 ramp #3 ramp #4
RIGHT
FLARE
LEFT
FLARE
1 Level Landing Depth - Ramp
1 Edge to Back of Landing or
Sidewalk
1 Level Landing Slope toward
2 Street %
1 Level Landing Slope %
3
1 Does the Curb Cut serve two
4 directions of Street Crossings
(Y/N)
1 Left Side Flare Slope %. If
5 greater than 4% measure #16, if
not go to #17
1 Left Side Flare Length
6
LEFT 1 Left Side Sidewalk Width
SIDE 7 (excluding curb)
SIDE 1 Left Side Sidewalk Cross Slope
WALK 8
S
1 Right Side Flare Slope %. If
9 greater than 4% measure #20, if
not go to #21
2 Right Side Flare Length
0
RIGH
T
SIDE
SIDE
WALK
S
OVE
RAL
L
CON
DIT
ON
2 Right Side Sidewalk Width
1 (excluding curb)
2 Right Side Sidewalk Cross Slope
2
2 Sidewalk & Ramp Distresses
3 (Frost Heaves, Vertical Lifts at
Cracks or Joints, Tree Roots)
See Coding (Add Note If
Necessary) See Coding (Add
Note If Necessary)
Save: 2013-May-01
C:\Users\brooksj\Desktop\Workspace\ADA CivilRights\From Michelle\Attachment 10a Curb Ramp Inventory Data sheet.doc
Blank
Wheel
Wheel
Wheel
Wheel
chair
chair
chair
chair
ramp #1 ramp #2 ramp #3 ramp #4
TRAFFIC DATA
2 Is this location signalized? (Y/N)
4 (If No Stop Here)
2 Is there a pedestrian actuated
5 crossing phase? (Y/N) (If No
Stop Here)
2 Is the signal APS (Y/N)
6
Save: 2013-May-01
C:\Users\brooksj\Desktop\Workspace\ADA CivilRights\From Michelle\Attachment 10a Curb Ramp Inventory Data sheet.doc
DRAFT Severity Index Range for Curb Cut
Wheelchair Ramp Data
SEVERITY
DESCRIPTION
Item 1
Item 2
No Severity
No Obstruction
Curb Blocking
Yes
No
Item 3
Type Identifier
Curb Blocking Path
Grade Breaks Perpendicular to
Path of Travel
Item 4
Item 5
Is ramp opening within Cross Walks Yes
Is tactile warning panel in place
Yes
Item 6
Item
6A
Item
6B
Ramp opening width at gutter
Change in level Roadway to Ramp
(Lip)
Evidence of Ponding on Ramp or at
Gutter
Gutter Slope (Parallel with Sidewalk
& Roadway)
Item 7
Item 8
Item 9
Item
10
Item
11
Item
12
Item
13
Item
14
Item
15
Item
16
Item
17
Item
18
Item
19
Item
20
Item
21
Item
22
Item
23
Slope of Street Perpendicular to
Gutter Line
Ramp Slope in Percent - 3
Measurements Left, Center and
Right
SEVERITY
DESCRIPTION
Less then 3'-0"
Measured "A"
Measured "B"
Measured "C"
No
Less or Equal to
2.0%
Yes
Gutter Slope + Ramp
Slope Less Than
10%
Gutter Slope + Ramp
Slope Between
10.1% and 15.0%
Less than 8.3%
Less or Equal to
2.0%
Less than 10%
Greater than 2.0% to
3.0%
Less than 48" but
Greater than 42"
Greater than 2.0% to
3.0%
Greater than 1.2% to
2.0%
Less or Equal to
8.3%
Less or Equal to
8.3%
Right Side Flare Length
Greater than 15 feet
Multiply 19 times 20 to determine severity index of Flare
Right Side Sidewalk Width
(excluding curb)
Greater than 5'-0"
Less or Equal to
2.2%
Right Side Sidewalk Cross Slope
Distress Codes
SEVERITY
SCORE
Greater than 4'-0
Left Side Flare Length
Greater than 15 feet
Multiply 15 times 16 to determine severity index of Flare
Left Side Sidewalk Width (excluding
curb)
Greater than 5'-0"
Less or Equal to
2.2%
Left Side Sidewalk Cross Slope
Right Side Flare Slope
SEVERITY
DESCRIPTION
No
No
Less than 4'-0"
Greater than 3'-0"
Cross Slope at Center of Ramp
Level Landing Depth - Ramp Break
toward Back of Walk
48' or greater
Less or Equal to
Level Landing Slope toward Street 2.0%
Level Landing Slope Parallel with
Less or Equal to
Street
1.2%
Multiply 12 times 13 to determine severity index of level landing
Does the curb cut serve 2
directions of street crossing. (Is
this an APEX Opening)
No
Left Side Flare Slope
SEVERITY
SCORE
No codes
2.1% to 5.0%
Yes
Greater than 8.3%
and Less than or
Equal to 10.0%
Greater than
5.0%
Gutter Slope +
Ramp Slope
Greater than
15.0%
Greater than 10%
Greater than
3.0%
Less than 42"
Greater than
3.0%
Greater than
2.0%
Greater than
10.0%
Less than 15 feet
Less than 5'-0" but
Greater than 4'-0"
Greater than 2.2% to
3.0%
Greater than 8.3%
and Less than or
Equal to 10.0%
Less than 4'-0"
Greater than
3.0%
Greater than
10.0%
Less than 15 feet
Less than 5'-0" but
Greater than 4'-0"
Greater than 2.2% to
3.0%
Less than 4'-0"
Greater than
3.0%
Each Distress Code
Each "+" Distress
Codes and
Obstructions and
Encroachments
SEVERITY
SCORE
Inventory Data Sheets and Instructions
The measurement team shall determine north and start the inventory on the leg
of the intersection to the east of north.
The first wheelchair ramp
will be the one on the left
of that first street east of
north. All wheelchair
ramps after that are
counted sequentially and
in a clockwise direction.
They should be numbered from the sending
wheelchair ramp on the
Median cut thru’s shall be
included sequentially in
the count. If the median is
6 feet or less the cut thru
is a single number, if the
median is greater than 6
feet the cut thru is 2
ramps with a shared
landing.
Delta islands with multiple
wheelchair ramps shall be
included in the sequence.
sidewalk, (n); the receiving wheel chair ramp on the delta island (n+1); and
continued clockwise around the island.
Measurements are determined left to right standing in the street looking at the curb
cut wheel chair ramp.
Note if there are poles or other obstructions in the wings or between ramps.
If an entire corner is depressed or the roadways elevated as with a speed table, the
corner can be considered as having 2 wheel chair ramps. This is unlike an apex
ramp which is a single ramp serving two directions of crossing and requiring a
turning area at the base of the ramp to select the crossing. Ramp 7 is not an apex
ramp as it serves only one direction of travel, to the island. If ramps 11 and 12 were
merged into a single ramp, serving crossings to ramp 13 and ramp 9, that would be
a apex ramp.
OK DRP FRI-2011-SEP-02
Distress codes
F
Faulting of surfaces at joints, cracks, utility covers or structures ¼ inch or less.
F+ Faulting as described above greater than ¼ inch.
R
Surface distress caused by tree roots.
Cll Crack ½ inch or less Parallel to the dominant direction of travel
Cll+ Crack more than ½ inch Parallel to the dominant direction of travel
CT Crack ½ inch or less Perpendicular to the dominant direction of travel
CT+ Crack more that ½ inch Perpendicular to the dominant direction of travel.
Objects in wheel chair ramps
UA-F Utility Access, Man Hole, Gate, Pull box etc. set flush with the surface in a
single plane surface.
UA-J Utility Access, Man Hole, Gate, Pull box etc. set across joints defining plane
surfaces of the wheel chair ramp
P
Signal, Sign, Utility Pole set in wing of wheel chair.
O
Hydrant, or Other element set in wing of wheel chair ramp
PE Pole Encroaching into the used portions of the wheel chair ramp.
OE Hydrant or Other element Encroaching into the used portion of the wheel chair
ramp.
Objects in the general path of travel (objects in/on the sidewalk and/or crosswalk
only. Objects in the road are not recorded.)
CB
MH
V
Catch Basin
Man Hole
Utility Vault
OK DRP FRI-2011-SEP-02