COLORADO DEPARTMENT OF TRANSPORTATION



|COLORADO DEPARTMENT OF TRANSPORTATION |

|PROJECT SCOPING/CLEARANCE RECORD |

|Construction Project # |Project Code |PE Project # |PE Project Code |STIP # |

|      | | | | |

| |      |      |      |      |

|Project Location |County |City |

|      |      |      |

|Begin point |End point |Region Program Engineer |Region |

|      |      |      |      |

|Who requested this project? For what reason? |

|      |

|      |

|What is the proposed improvement/scope of work? (Note changes as project develops) |

|      |

|      |

|Phase descriptions: (see Procedural Directive 512.1 for further |Comments: |

|information/instructions) |1) The Form 1048a is to be used in conjunction with the Project |

|Phase I- |Development Manual. |

|Implementation to Statewide Transportation Improvement Program (STIP). As a |2) The Resident Engineer typically delegates project management |

|project is included in the STIP, these activities should be reviewed for scoping |responsibilities to other positions based on the type of project and |

|the project, identifying concerns and determining future budget requirements. |available expertise. |

|Phase II- |3) Documentation or activity sign-off date indicates clearance. All |

|Design Scoping Review (DSR) – Takes place in the year before Preliminary |certification boxes require concurrence before project may be |

|Engineering (PE) is budgeted or immediately when PE is budgeted, to re-evaluate |advertised. Use N/A if not applicable. |

|original scope. May be combined with pre-survey conference. |4) Blanks may be filled in a variety of ways. N/A = Not Applicable. |

|Phase III- |Check when item is completed. If activity is applicable, show date |

|Field Inspection Review (FIR) – Before or during the FIR, all project development |completed and initial. |

|and design needs identified in the scoping process must be resolved. The scope |Check “clear box as each activity is cleared. |

|should not be changed after the FIR. |5) ???=Not yet determinable. |

Activity

|Section 1 |Phase I |Phase II |Phase III |C |Certification/clearance |

|Scoping, budgeting and programming |Implementation to |Design Scoping |Field Inspection |L | |

| |STIP |Review |Review |E | |

| | | | |A | |

| | | | |R | |

| | | | | |Responsible party or|Documentation or |

| | | | | |reviewer |activity sign-off |

| | | | | | |date |

|Existing typical section |      |      |      | | | |

|1.08 Field survey required Yes No |      |Completed date |      | |Region Survey |      |

|Date requested: | |      | | |Coordinator | |

| Design Data (Form 463a) |      |Preliminary:      |Final:       | |Resident Engineer |      |

| | |Date:      |Date:       | | | |

|1.10 Request for Design Exception (Form |      | N/A | N/A | |Resident Engineer |      |

|464a) (Attach to Form 463a) | |Applicable |Sent | | | |

|Project schedule prepared |      | Yes No | Up-to-date | |Resident Engineer |      |

| | |Date: |Date:       | | | |

Page 1 of 6 CDOT Form 1048a 5/01

|Section 2 |Phase I |Phase II |Phase III |C |Certification/clearance |

|Environmental |Implementation to |Design Scoping |Field Inspection |L | |

| |STIP |Review |Review |E | |

| | | | |A | |

| | | | |R | |

| | | | | |Responsible party or|Documentation or |

| | | | | |reviewer |activity sign-off |

| | | | | | |date |

| |Yes No Check |Yes No Check |Status: | | |

|2.01 Route location approval | | |      | |Region Planning / Environmental Manager |

|Major Intermediate certification | | | | |(shaded area below) |

|Minor Compliance (Form 128) | | | | |      |

|2.02 Public involvement | | |      | | |

|2.22 Landscaping | | |      | | |

| | | | | |Responsible party or|Documentation or |

| | | | | |reviewer |activity sign-off |

| | | | | | |date |

| | | |Status: | | |

|3.01 Traffic data (Form 463a and title |      |Available?       |      | |Resident Engineer |      |

|sheet) | |Yes No | | | | |

|Request / analyze crash data | Yes No |Status:       |      | |Region Traffic |      |

|Hazard index: | | | | | | |

|Request turning movements from |      | Yes No |      | |Resident Engineer |      |

|DTD | | | | | | |

|Shown on the plans | | | | | | |

|Signal warrants |      |      |      | |Region Traffic |      |

|On file | | | | | | |

|3.05 Traffic movement diagram |      | Requested |      | |Resident Engineer |      |

|Intersection layout req’d Yes No | |Requested | | | | |

|Interchange layout req’d Yes No | | | | | | |

|3.06 Intersection / interchange design |Required? |Required?       |      | |Resident Engineer |      |

|Yes No | |Requested       | | | | |

|3.07 Traffic signal plan |      | Yes No |      | |Project Traffic |      |

| | | | | |Engineer | |

|3.08 Lighting plan |      | Yes No |      | |Resident Engineer |      |

|Permanent signing and pavement |      |Required?       |      | |Project Traffic |      |

|marking | |Yes No | | |Engineer | |

|3.10 Construction traffic control plans |      | Yes No |      | |Project Traffic |      |

|(signing, signals and pavement | | | | |Engineer | |

|marking) | | | | | | |

|Section 4 |Phase I |Phase II |Phase III |C |Certification/clearance |

|Structures |Implementation to |Design Scoping |Field Inspection |L | |

| |STIP |Review |Review |E | |

| | | | |A | |

| | | | |R | |

| | | | | |Responsible party or|Documentation or |

| | | | | |reviewer |activity sign-off |

| | | | | | |date |

| |Yes No Check |Yes No Check |Status: | | | |

|4.01 Major structure - bridge | | |      | |Project Structural |      |

| | | | | |Engineer | |

|4.02 Major structure --culvert | | |      | |Project Structural |      |

| | | | | |Engineer | |

|4.03 Major structure - unusual | | |      | |Project Structural |      |

| | | | | |Engineer | |

|4.04 Pedestrian overpass / underpass | | |      | |Project Structural |      |

| | | | | |Engineer | |

|4.05 Architectural / aesthetic treatment | | |      | | | |

|4.07 Structure selection report | | |      | |Project Structural |      |

| | | | | |Engineer | |

|4.08 Retaining walls | | |      | |Project Structural |      |

| | | | | |Engineer | |

|4.09 Noise walls | | |      | |Project Structural |      |

| | | | | |Engineer | |

|4.10 Analysis of structures to be | | Req’d |      | |Project Structural |      |

|resurfaced | |Requested | | |Engineer | |

|4.11 Determine existing structural | |OK N/A Check |      | |Project Structural |      |

|adequacy | | | | |Engineer | |

|4.12 Crashworthy bridge rail | |OK N/A Check |      | |Project Structural |      |

| | | | | |Engineer | |

|4.13 Vertical clearance of structure | |OK N/A Check |      | |Resident Engineer |      |

Page 3 of 6 CDOT Form 1048a 5/01

|Section 5 |Phase I |Phase II |Phase III |C |Certification/clearance |

|Materials |Implementation to |Design Scoping |Field Inspection |L | |

| |STIP |Review |Review |E | |

| | | | |A | |

| | | | |R | |

| | | | | |Responsible party or|Documentation or |

| | | | | |reviewer |activity sign-off |

| | | | | | |date |

| | | |Status: | | | |

|5.01 Pavement analysis / distress |Type: |Type: |Type: | |Region Materials |      |

| |      |      |      | |Engineer | |

|Foundation investigation and | |Yes No Request |Status: | |Resident Engineer |      |

|drilling | | |      | | | |

|5.03 Geotechnical studies | |Yes No Request |Status: | |Geology Program |      |

| | | |      | | | |

|5.04 Pit option | |Yes No Check |Status: | |Resident Engineer |      |

| | | |      | | | |

|5.05 Pit reclamation requirements | | |Yes No Check | |Resident Engineer |      |

|5.06 Pavement justification report | | |Status: | |Region Materials |      |

| | | |      | |Engineer | |

|Alternate pavement design | | |Status: | |Region Materials |      |

|(life cycle cost analysis) | | |      | |Engineer | |

|      |      |      |      | | |      |

|      |      |      |      | | |      |

|      |      |      |      | | |      |

|Section 6 |Phase I |Phase II |Phase III |C |Certification/clearance |

|Right of Way and Utilities |Implementation to |Design Scoping |Field Inspection |L | |

| |STIP |Review |Review |E | |

| | | | |A | |

| | | | |R | |

| | | | | |Responsible party or|Documentation or |

| | | | | |reviewer |activity sign-off |

| | | | | | |date |

|6.01 Right-of-way involvement |Yes No Type |Yes No Check |Status: | |ROW Manager |      |

|Access control? |      | | | | | |

|Easement acquisition required? |      |# =      |      | | | |

|Relocation assistance | |# =      |      | | | |

|Trespass permit required? | |# =      |      | | | |

|Advertising signs (commercial) | |Type: |      | | | |

|Illegal Legal | | | | | | |

|Existing easements | |Type: |Yes No # | | | |

|Identify       | | |      | | | |

|Clearance | | | | | | |

|6.02 Permits req’d to work on govt. |Yes No |Yes No Check |Status:      | |Resident Engineer |      |

|land |??? | | | | | |

|Forest Service | | | | | | |

|Bureau of Land Management | | | | | | |

|1.       | | | | | | |

|2.       | | | | | | |

| | | | | | | |

|6.03 Utility involvement |Yes No ???|Yes No Check |Status:      | |Region Utility |      |

|Existing utility easements? | |Status:      | | |Engineer | |

|Visual inspection | |Date:      | | | | |

|Request locates | | | | | | |

|Clearance | | |Yes No | | | |

|6.04 Railroad involvement |Yes No |Yes No Check |Status:      | |Resident Engineer |      |

|1.       |??? | | | | | |

|2.       | | | | | | |

|      |      |      |      | | |      |

|      |      |      |      | | |      |

|      |      |      |      | | |      |

Page 4 of 6 CDOT Form 1048a 5/01

|Section 7 |Phase I |Phase II |Phase III |C |Certification/clearance |

|Agreements, Justifications and Approvals |Implementation to |Design Scoping |Field Inspection |L | |

| |STIP |Review |Review |E | |

| | | | |A | |

| | | | |R | |

| | | | | |Responsible party or|Documentation or |

| | | | | |reviewer |activity sign-off |

| | | | | | |date |

|7.01 Safety rest areas |Yes No ???|Yes No Check |Status:       | |Resident Engineer |      |

| | | | | | | |

|7.02 Detour design |Yes No ???|Yes No Check |Status:       | |Resident Engineer |      |

| | | | | | | |

|7.03 Frontage road design |Yes No ???|Yes No Check |Status:       | |Resident Engineer |      |

| | | | | | | |

|Railroad design |Yes No ???|Yes No Check |Status:       | |Resident Engineer |      |

|RR company       | | | | | | |

|RR flagging and insurance requirements | | | | | | |

|RR facilities | | | | | | |

|RR standards reviewed |Yes No | | | | | |

| |Yes No | | | | | |

|7.05 Airport / heliport clearances |Req’d ??? |Yes No Check |Status:       | |Resident Engineer |      |

| |Yes No | | | | | |

|7.06 Americans With Disabilities Act |Yes No |Yes No Check |Status:      | |Resident Engineer |      |

|standards |??? | | | | | |

| | | | | | | |

|Bicycle and pedestrian facilities |Yes No |Yes No Check |Status:       | |Resident Engineer |      |

|Standards reviewed |??? | | | | | |

| | | | | | | |

|7.08 Transit accommodations |Yes No |Yes No Check |Status:       | |Resident Engineer |      |

| |??? | | | | | |

| | | | | | | |

|Safety review | |Applicable |Status:       | |Resident Engineer |      |

|(including clear zone decisions) | |Yes No | | | | |

|7.10 Resurfacing project safety letter | | |Date:       | |Resident Engineer |      |

|7.11 Guardrail/ barrier design and | |Need ??? |Yes No Check | |Resident Engineer |      |

|review | |Yes No | | | | |

|Hydraulic design | |Yes No Check |Status:       | |Hydraulics Engineer |      |

|Erosion control | | | | | | |

|Stormwater quality | | | | | | |

|management | | | | | | |

|Culverts other than Bid Items 617 | | | Justified | |Resident Engineer |      |

|and 624 | | |Status:       | | | |

|7.14 Climbing and passing lanes | |Yes No |Yes No Check | |Resident Engineer |      |

| | |??? | | | | |

| | | | | | | |

|7.15 Stockpass and machine pass | |Yes No |Yes No Check | |Resident Engineer |      |

| | |??? | | | | |

| | | | | | | |

|7.16 Alternate bids | |Yes No |Yes No Check | |Program Engineer |      |

| | |??? | | | | |

| | | | | | | |

|7.17 Consolidated projects | | |Applicable | |Resident Engineer |      |

| | | |Yes No | | | |

|Special provisions | | |Yes No Check | |Resident Engineer |      |

|Reviewed by | | | | | | |

|7.19 Consultant selection and |Yes No |Yes No Check |Status:       | |Agreements |      |

|contracting process |??? | | | | | |

| | | | | | | |

|7.20 Entity agreement (local agency, |Yes No |Yes No Check |Status:       | |Agreements |      |

|intergovernmental, interagency, public, |??? | | | | | |

|private) | | | | | | |

|1.       | | | | | | |

|2.       | | | | | | |

|7.21 Irrigation company agreement |Yes No |Yes No Check |Status:       | |Region Utility |      |

|1.       |??? | | | |Engineer | |

|2.       | | | | | | |

Page 5 of 6 CDOT Form 1048a 5/01

|Section 8 |Phase I |Phase II |Phase III |C |Certification/clearance |

|General |Implementation to |Design Scoping |Field Inspection |L | |

| |STIP |Review |Review |E | |

| | | | |A | |

| | | | |R | |

| | | | | |Responsible party or|Documentation or |

| | | | | |reviewer |activity sign-off |

| | | | | | |date |

|8.01 Force account and FIPI |Yes No |Yes No Check |Yes No Date | |Region Program |      |

|(Form 895) |??? | |      | |Engineer | |

| | | | | | | |

|8.02 Method of construction |Yes No |Yes No Check |Yes No Date | |Resident Engineer |      |

| |??? | |      | | | |

| | | | | | | |

|8.03 Work by others (with federal aid) |Yes No |Yes No Check |Yes No Date | |Resident Engineer |      |

| |??? | |      | | | |

| | | | | | | |

|8.04 Work by state forces |Yes No |Yes No Check |Yes No Date | |Resident Engineer |      |

| |??? | |      | | | |

| | | | | | | |

|8.05 Value Engineering | |Yes No Check |Yes No N/A | |Resident Engineer |      |

|Stage construction | |Yes No Check |Yes No Check | |Resident Engineer |      |

|(future capacity considerations) | | | | | | |

|8.07 Experimental items | |Yes No Check |Yes No Date | |Region Program |      |

| | | |      | |Engineer | |

|8.08 Mandatory source of materials | |Yes No Check |Yes No Date | |Resident Engineer |      |

| | | |      | | | |

|8.09 Design Scoping Review | |Date:       | | |Resident Engineer |      |

|Field Inspection Review | | |Date(s):       | |Resident Engineer |      |

|Combined FIR/FOR | | | | | | |

|8.11 Design Office Review | | |Date(s):       | |Resident Engineer |      |

|8.12 **Final Office Review | | |Date(s):       | |Resident Engineer |      |

|Design decision letter | |Date(s):       |Date(s):       | |Resident Engineer |      |

|Applicable Yes No | | | | | | |

|8.14 Disposal of excess materials off project| | |Yes No Date | |Resident Engineer |      |

|site | | |      | | | |

|8.15 Use of materials furnished by a public | | |Yes No Date | |Region Program |      |

|agency | | |      | |Engineer | |

|8.16 Propriety items | | |Yes No Date | |Region Program |      |

| | | |      | |Engineer | |

|**On-the-job trainee approval | | |Yes No Date | |Region EEO/Civil |      |

|Force account | | |      | |Rights Specialist | |

|Special reviewed | | | | | | |

|**Disadvantaged Business | | |Yes No Status | |Region EEO/Civil |      |

|Enterprise goals | | |      | |Rights Specialist | |

|8.19 **Project control data (Form 859a) | | |Status:       | |Region Program |      |

| | | | | |Engineer | |

|8.20 **PS&E approval | | |Date:       | |Resident Engineer |      |

| | | |Date:       | | | |

|**Federal-aid program data (Form | | | | |OFMB |      |

|418) | | | | | | |

|8.22 **Bid package reviewed | | |Date:       | |Resident Engineer |      |

|Region FHWA | | | | | | |

|8.23 **Advertisement | | | | |Resident Engineer |      |

|8.24 **PS&E revisions under ad | | |Date:       | |Resident Engineer |      |

|Approved Yes No | | | | | | |

| **Re-advertisement | | | | |Region Program |      |

| | | | | |Engineer | |

|**Estimate Review by Eng. | | | | |Engineer Estimating |      |

|Estimating | | | | | | |

**Report status in Phase III column, activity usually falls after FIR. Page 6 of 6 CDOT Form 1048a 5/01

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download