Final Design Phase Scope Statement Template



FORMTEXT <Project Name> Purpose: The Final Design (FD) Scope Statement lists the project’s deliverables and the activities required to create those deliverables in the Final Design phase of the project delivery process. The scope statement also provides a common understanding of the project’s scope to stakeholders, subject matter experts and the designer, and it lists the project’s major objectives. It enables the Project Manager to perform Final Design and it helps guide the design team’s work during execution, and provides the baseline for evaluating whether change requests or additional work are contained within or outside the project’s boundaries. Notes: The intent of the FD Scope Statement is to provide useful project information to designers who will be performing the FD work for this project. In addition, it will be used to solicit a man-hour estimate and cost proposal. The FD Scope Statement identifies the key elements of FD that are necessary to advance the proposed project to construction. The FD Scope Statement is developed by the Division of Project Management (DPM) Project Manager and the Preliminary Engineering (PE) Designer near the conclusion of the PE phase, prior to requesting the services of a designer to perform FD. The Scope of Work section is approved by the appropriate Subject Matter Experts (SMEs). Section 1 of the document focuses on Proposed Project Identification Information and FD and Construction data including the project’s location and description. Section 2 of the document specifies the Scope of Work for FD. PROPOSED PROJECT IDENTIFICATION INFORMATIONProposed Project SpecificsProposed Project NameLimits FORMTEXT ????? FORMTEXT ?????NJDOT Project Manager NJDOT Executive Regional Manager FORMTEXT ????? FORMTEXT ?????CountiesMunicipalities FORMDROPDOWN FORMDROPDOWN FORMDROPDOWN FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????UPC Number FORMTEXT ?????DB Number FORMTEXT ?????Legislative District(s) FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Congressional District (s) FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Route FORMTEXT ?????Start Milepost FORMTEXT ?????End Milepost FORMTEXT ?????Alternate Route FORMTEXT ?????Alternate Start Milepost FORMTEXT ?????Alternate End Milepost FORMTEXT ?????STIP Information FORMTEXT ?????Structure Numbers FORMTEXT ?????Project Classification: FORMDROPDOWN MPO FORMTEXT ?????Project EstimateList the Project Estimates for each category.Project Item:FD Phase Estimated AmountDesign FORMTEXT $ROW FORMTEXT $Utility Relocation FORMTEXT $Construction FORMTEXT $Construction Engineering FORMTEXT $Contingencies FORMTEXT $Total FORMTEXT $Concept Development and Preliminary Engineering InformationDate of Concept Development Report: FORMTEXT ?????Date of Federal Approval of CD Report: FORMTEXT ?????Date of Preliminary Engineering Report: FORMTEXT ?????Date of Design Exception Report: FORMTEXT ?????Date of Federal Approval of Environmental Classification: NEPA FORMTEXT ?????Date of Project Plan: FORMTEXT ?????Date of CPC decision to advance project to PE: FORMTEXT ?????PE Designer: FORMTEXT ?????FD to be Completed by (check one): FORMCHECKBOX In-House FORMCHECKBOX ConsultantPurpose and Need: FORMTEXT ?????Description of Preliminary Preferred Alternative: FORMTEXT ?????Project Goals and Objectives: FORMTEXT ?????Final Design Information (to be filled in upon selection of a designer)FD Designer: FORMTEXT ?????FMIS Contract ID Number (e.g., 89 00766): FORMTEXT ?????Funding Source: FORMTEXT ?????Agreement Number (e.g., 2001PM03): FORMTEXT ?????Type of Specifications: FORMTEXT ?????Construction Information CM Job Number: FORMTEXT ?????Duration of Construction: FORMTEXT ?????Award Date (actual/anticipated): FORMTEXT ?????Estimated Construction Year: FORMTEXT ?????Final Design Deliverables4.1 Final Design Initiation FORMCHECKBOX Seismic Retrofit Analysis FORMCHECKBOX Utility Authorization FORMCHECKBOX Financial Plan (for Major Projects) FORMCHECKBOX Noise Barrier Detail Plans FORMCHECKBOX Alternatives of Accommodation plan 4.2 Roadway Engineering FORMCHECKBOX Geotechnical Roadway and Rock Engineering Report4.6 Quality Management-Certifications FORMCHECKBOX Revised Pavement Recommendation FORMCHECKBOX Boring and In-situ Testing Layout Plan FORMCHECKBOX FD Quality Management Certification FORMCHECKBOX Final Horizontal/Vertical Geometry FORMCHECKBOX Boring Contract Specifications FORMCHECKBOX Department Certification FORMCHECKBOX Final Design Supplemental Survey FORMCHECKBOX Boring Data Submission4.7 Communications FORMCHECKBOX Traffic Lighting Design Report 4.4 Right of Way and Access FORMCHECKBOX Design Communications Report FORMCHECKBOX Traffic Control and Staging Plans FORMCHECKBOX Final Right of Way Cost Estimate FORMCHECKBOX Community Relations FORMCHECKBOX Soil Erosion and Sediment Control Report FORMCHECKBOX Pre-Final Right of Way Submission FORMCHECKBOX Resolution of Support FORMCHECKBOX Soil Erosion and Sediment Control Plans FORMCHECKBOX Final Right of Way Submission FORMCHECKBOX Traffic Regulation Order Confirmation Letter FORMCHECKBOX Jurisdictional Limit Maps and Agreement FORMCHECKBOX Right of Way Authorization4.8 Environmental Documents FORMCHECKBOX Final Drainage Plans FORMCHECKBOX Acquired Right of Way FORMCHECKBOX Environmental Reevaluations FORMCHECKBOX Final Drainage Design Report FORMCHECKBOX Riparian License Application FORMCHECKBOX Environmental Permits and Licenses FORMCHECKBOX Final Lighting Plans FORMCHECKBOX Access Cut-Outs FORMCHECKBOX Final Environmental Plans FORMCHECKBOX Final Roadway Plans FORMCHECKBOX Access Impact Assistance Report FORMCHECKBOX State House Commission Approval for Green Acres Parcels FORMCHECKBOX Final Traffic Signing, Striping and Signal Plans FORMCHECKBOX Lot Owner Lease Agreement FORMCHECKBOX Conceptual Wetlands Mitigation Plans FORMCHECKBOX Final Landscape Plans FORMCHECKBOX Lot Owner Access Concurrence FORMCHECKBOX Final Noise Study FORMCHECKBOX Final ITS Facilities Plans FORMCHECKBOX Green Acres Compensation Appraisal FORMCHECKBOX Reforestation Application FORMCHECKBOX Hydrologic and Hydraulic Stream Analysis FORMCHECKBOX Title Summary Document FORMCHECKBOX Final Wetlands Mitigation Plans FORMCHECKBOX Flood Hazard Area Permit Application FORMCHECKBOX Entire Tract Map FORMCHECKBOX Asbestos Survey FORMCHECKBOX Railroad 60% Submission FORMCHECKBOX General Property Parcel Maps FORMCHECKBOX Remedial Action Workplan FORMCHECKBOX Diagnostic Team Meeting (DTM) Memo of Record or Order FORMCHECKBOX Individual Parcel Maps FORMCHECKBOX PAECE Report FORMCHECKBOX Railroad 100% Submission FORMCHECKBOX Parcel Descriptions FORMCHECKBOX Noise Mitigation Questionnaire FORMCHECKBOX Final Design Systems Engineering Review Form (SERF)4.5 Utility Engineering FORMCHECKBOX Wetlands Monitoring Plan4.3 Structural Engineering FORMCHECKBOX Utility Owner Design Authorization Checklist FORMCHECKBOX Wetlands Delineation Report FORMCHECKBOX Final Structure Appraisal and Design Report FORMCHECKBOX Supplemental SUE Report FORMCHECKBOX Cultural Resources Mitigation Report FORMCHECKBOX Geotechnical Foundation Engineering Report FORMCHECKBOX Utility Agreement Plans, Specs., & Estimates FORMCHECKBOX Environmental Summary Memorandum FORMCHECKBOX Final Structures Documents FORMCHECKBOX Utility Agreement Modifications FORMCHECKBOX Site Investigation Report FORMCHECKBOX Scour Analysis FORMCHECKBOX Utility Master Agreement Change Order FORMCHECKBOX Remedial Investigation Report4.9 Final Design Submission4.10 Certified Plans, Specifications, and Estimate4.11 Contracts FORMCHECKBOX Interim Design Submission (Optional) FORMCHECKBOX Pre-PS&E Package (Full Oversight Only) FORMCHECKBOX Consultant Agreement Addendums FORMCHECKBOX Project Plans FORMCHECKBOX Final Project Plans FORMCHECKBOX Final Invoice FORMCHECKBOX Project Specifications FORMCHECKBOX Final Project Specifications4.12 Final Design Approvals FORMCHECKBOX Construction Cost Estimate FORMCHECKBOX Final Construction Cost Estimate FORMCHECKBOX Advertising Authorization Package FORMCHECKBOX Construction Schedule FORMCHECKBOX Final Construction Schedule FORMCHECKBOX Authorization to Advertise FORMCHECKBOX Certifications and Clearances FORMCHECKBOX Updated PM Plans (Major Projects) Summary of CommitmentsList any commitments made to the public, local officials or other government agencies: Project CommitmentUnit Requesting the CommitmentUnit Fulfilling Commitment Special Needs FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????List any anticipated commitments that may be made: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????ApprovalNameTitleDate Approved FORMTEXT ?????ManagerBureau of Landscape Architecture and Environmental Solutions FORMTEXT ????? FORMTEXT ?????DirectorDivision of Construction Services and Materials FORMTEXT ????? FORMTEXT ?????Project ManagerDivision of Project Management FORMTEXT ????? FORMTEXT ?????Executive Regional ManagerDivision of Project Management FORMTEXT ????? FORMTEXT ?????DirectorDivision of Project Management FORMTEXT ?????FINAL DESIGN SCOPE OF WORKTable of ContentsPage TOC \o "1-3" \h \z \u Right of Way PAGEREF _Toc5975142 \h 8Access PAGEREF _Toc5975143 \h 11Drainage PAGEREF _Toc5975144 \h 13Landscape PAGEREF _Toc5975145 \h 15Environmental PAGEREF _Toc5975146 \h 17Value Engineering PAGEREF _Toc5975147 \h 21Utilities PAGEREF _Toc5975148 \h 21Jurisdiction PAGEREF _Toc5975149 \h 25Geometrics & Roadway PAGEREF _Toc5975150 \h 26Pavement PAGEREF _Toc5975151 \h 29Structures PAGEREF _Toc5975152 \h 30Geotechnical PAGEREF _Toc5975153 \h 33Survey PAGEREF _Toc5975154 \h 35Railroads PAGEREF _Toc5975155 \h 37Construction & Risk Analysis PAGEREF _Toc5975156 \h 38Traffic Engineering PAGEREF _Toc5975157 \h 40Electrical Maintenance PAGEREF _Toc5975158 \h 42Maintenance and Operations PAGEREF _Toc5975159 \h 43Traffic Operations and Intelligent Transportation System (ITS) Engineering PAGEREF _Toc5975160 \h 45Commuter Mobility PAGEREF _Toc5975161 \h 47Technical and Administrative Activities PAGEREF _Toc5975162 \h 48Summary of Approvals PAGEREF _Toc5975163 \h 51NOTE: The FD Designer will perform the tasks associated with FD as marked, in preparation for construction. The Project Manager will review and negotiate the proposal, execute the Agreement and instruct the designer to begin work. The Project Manager will direct the project through FD.Right of WayActivity No.Activity NameExecuteResponsible UnitComments4600Conduct Title Search FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX ROW FORMTEXT ?????4605Prepare ROW Plans and Documents FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMTEXT ?????4610Review ROW Plans and Documents FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMTEXT ?????4615Prepare Pre-Final ROW Submission FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMTEXT ?????4620Review Pre-Final ROW Submission FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX ROW FORMCHECKBOX DPM FORMCHECKBOX Designer FORMTEXT ?????4625Prepare Final ROW Submission FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMTEXT ?????4630Process Final ROW Submission FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX ROW FORMTEXT ?????4635Hold ROW Acquisition Kickoff Meeting FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX ROW FORMCHECKBOX DPM FORMCHECKBOX Designer FORMTEXT ?????4650Authorize Right of Way FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX ROW FORMCHECKBOX FHWA FORMTEXT ?????4655Prepare Riparian License Application FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX ROW FORMCHECKBOX Designer FORMTEXT ?????4660Secure Riparian License FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX ROW FORMTEXT ?????4665Perform Asbestos Survey FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX ROW FORMCHECKBOX DPM FORMCHECKBOX Designer FORMCHECKBOX CM FORMCHECKBOX Consultant FORMTEXT ?????4670Acquire ROW FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX ROW FORMCHECKBOX DAG FORMCHECKBOX Consultant FORMCHECKBOX DPM FORMCHECKBOX Designer FORMCHECKBOX CM FORMTEXT ?????Total Number of Parcels: FORMTEXT ?????1. Fee Parcel /EasementsNumber of fee parcels (partial): FORMTEXT ?????Number of fee parcels (entire): FORMTEXT ?????Number of residential relocations: FORMTEXT ?????Number of permanent easements (E parcels): FORMTEXT ?????Number of temporary easements: FORMTEXT ?????Number of commercial relocations: FORMTEXT ?????2. List any known or potential environmental problems or issues that may impact Right of Way processes or decisions (cross reference with the Environmental section of the Scope Statement document: FORMTEXT ?????3. List any environmentally sensitive parcels (ESPs), underground storage tanks, freshwater wetlands: FORMTEXT ?????4. Identify Riparian Parcels (currently flowed), Easements and/or Green Acres Diversions by contacting NJDEP for any Right of Way to be acquired: FORMTEXT ?????5. Identify parcels that can be eliminated by design change modifications and attempts to mitigate damages suffered by the remaining properties. FORMTEXT ?????6. Decision to expand parcel for further use or contingency. FORMTEXT ?????7. List the number of Non Real Estate Engineering (NRE) parcels. FORMTEXT ?????8. List any commitments and conditions made to the public or to private property owners that may impact Right of Way processes or decisions: FORMTEXT ????? (Also list commitments in the Summary of Commitments page in Section 1 above.)9. Green Acres mitigation method: FORMCHECKBOX Dollar Reimbursement FORMCHECKBOX Property Replacement 10. List any full parcel takings: FORMTEXT ????? How much lead time is needed to meet the schedule? FORMTEXT ?????11. List any parcels containing structures that need maintenance, or other parcels that may need maintenance, and the type of maintenance: (e.g., boarding up windows, mowing, shoveling snow off sidewalks, etc.) FORMTEXT ????? 12. List any parcels that will need asbestos testing or asbestos removal: FORMTEXT ????? List any parcels that have structures that will have a demo contract: FORMTEXT ?????How much lead time is needed to meet the schedule? FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.Examples of information for this section include number and type of parcels, known environmental problems, riparian parcels, public commitments, etc. 06096000 FORMTEXT ?????AccessActivity No.Activity NameExecuteResponsible UnitComments4705Prepare Access Cut-Outs FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMTEXT ?????4710Review Access Cut-Outs FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX OAD FORMCHECKBOX Designer FORMTEXT ?????4715Administer Access Alterations FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX OAD FORMCHECKBOX Designer FORMTEXT ?????Number of Adjustments: FORMTEXT ?????Number of Modifications: FORMTEXT ?????Number of Revocations: FORMTEXT ?????Note any pending agreements or access applications within the project limits: FORMTEXT ?????Are left turn lanes in compliance with the Access Level? FORMCHECKBOX Yes FORMCHECKBOX NoIs the Typical Section of the roadway in compliance with the Highway Access Code? FORMCHECKBOX Yes FORMCHECKBOX NoTotal Number of Driveways impacted: FORMTEXT ?????Are there any commercial properties with access modifications and/or Revocations that have potential impacts to site parking slots, circulations and operation of business? FORMCHECKBOX Yes FORMCHECKBOX No If yes, provide details of impact with Block and Lot Nos. FORMTEXT ?????Are there any commercial properties that will require necessary assistance in the establishment of the alternative access (as per NJAC 16:47-4.33)? FORMCHECKBOX Yes FORMCHECKBOX No If yes, provide details of assistance with Block and Lot Nos. FORMTEXT ?????Are there any commercial properties that will require the preparation of an Access Impact Assistance (AIA) report. FORMCHECKBOX Yes FORMCHECKBOX No If yes, provide Block and Lot Nos. FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number. List any commitments in the Summary of Commitments in Section 1 above.Examples of information for this section include number of driveways impacted, pending agreements or major access permit applications, driveway modifications causing circulation issues, alternative access issues, Access Impact Assistance issues, etc. 06096000 FORMTEXT ?????DrainageActivity No.Activity NameExecuteResponsible UnitComments4270Complete Drainage Design FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX H & H FORMCHECKBOX Designer FORMTEXT ?????4310Complete Hydrologic & Hydraulic Analysis FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX H & H FORMCHECKBOX Designer FORMTEXT ?????4315Complete Final Bridge Analysis FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX H & H FORMCHECKBOX Designer FORMTEXT ?????Identify all existing drainage deficiencies (undersized system, excessive spread into travel lanes, insufficient inlets, flooding at low points, etc.): FORMTEXT ?????List proposed improvements including outfalls (especially tidal): FORMTEXT ?????Is compliance with Stormwater Management rules triggered (> 1/4 acre new impervious surface, or 1 acre disturbance)? FORMCHECKBOX Yes FORMCHECKBOX NoIdentify all NJDEP permits required: FORMTEXT ?????List proposed structural Best Management Practices (BMP) (Bioretention System, Constructed Wetlands, extended detention basins, infiltration system, wet ponds, porous pavement and etc.): FORMTEXT ?????List proposed nonstructural BMP (such as Vegetation and Landscaping, Minimized Site Disturbance, Impervious Area Management, and Time of Concentration Modifications): FORMTEXT ?????Identify drainage outflow owner: FORMTEXT ????? Will property rights need to be acquired? FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.Examples of information for this section include drainage deficiencies, new/improved outfalls, storm water management rules, permits, Best Management Practices (structural and non-structural), easements/right of way, etc. List any commitments in the Summary of Commitments in Section 1 above.06096000 FORMTEXT ?????Landscape Activity No.Activity NameExecuteResponsible UnitComments4175Prepare Noise Barrier Details FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX Landscape FORMTEXT ?????4260Develop Landscape Architectural Design FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX Landscape FORMTEXT ?????4265Complete Landscape Architectural Design FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Landscape FORMCHECKBOX Designer FORMTEXT ?????4375Prepare Final Wetlands Mitigation Plans FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMCHECKBOX Landscape FORMTEXT ?????4440Submit Reforestation Applicaton FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Landscape FORMTEXT ?????4450NJDEP Reviews Reforestation Application FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Comm. Forest Council FORMCHECKBOX DEP FORMTEXT ?????1. List any landscape architecture related commitments such as:a. Wetland or Riparian Mitigation Planting: FORMTEXT ?????b. Historic Site commitments FORMTEXT ?????c. Vegetative Screens or Buffers FORMTEXT ?????d. Noise Barrier Aesthetics: FORMTEXT ?????e. Architectural Treatments on Structures (e.g., Bridges, Retaining Walls, Parapets, Noise Barriers, Visible drainage culverts/structures, etc.) FORMTEXT ?????f. Tree Removal Mitigation: FORMTEXT ?????g. Urban Design Work (paving, streetscapes): FORMTEXT ?????h. Aesthetic plantings: FORMTEXT ?????i. Existing tree preservation and protection: FORMTEXT ?????j. Reforestation Application: FORMTEXT ?????k. Pocket Parks FORMTEXT ?????l. Green Acres Mitigation FORMTEXT ?????m. Acid Soils FORMTEXT ?????n. Storm Water Management facilities FORMTEXT ?????2. Anticipated visualization work for in-house and public information meetings:a. Rendered Plans: FORMTEXT ?????b. 2D computer generated before & after photographs: FORMTEXT ?????c. 3D computer generated model: FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments in the Summary of Commitments in Section 1 above.Examples of information for this section include screens or buffers, aesthetic plantings, mitigation plantings, reforestation, etc.06096000 FORMTEXT ?????EnvironmentalActivity No.Activity NameExecuteResponsible UnitComments4075Obtain Utility Environmental Reevaluation FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMTEXT ?????4140Submit Draft Final Noise Study FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMTEXT ?????4145Obtain Noise Mitigation Community Support FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX CCR FORMCHECKBOX Designer FORMTEXT ?????4150Submit Final Noise Study FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMTEXT ?????4360Delineate Wetlands FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMTEXT ?????4350Prepare Conceptual Wetlands Mitigation Plans FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMTEXT ?????4355Prepare Wetlands Monitoring Plan FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMTEXT ?????4375Prepare Final Wetlands Mitigation Plans FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMCHECKBOX Landscape FORMTEXT ?????4380NJDEP Approves Wetland Mitigation Plans FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX DEP FORMTEXT ?????4385Prepare Permit Application FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMTEXT ?????4390Review and Submit Permit Application FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMCHECKBOX H&H FORMTEXT ?????4395Secure Permits FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMCHECKBOX H&H FORMCHECKBOX Permit. Agencies FORMTEXT ?????4410Prepare Soil Erosion and Sediment Control Report and Plans FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMTEXT ?????4430Review Soil Erosion and Sediment Control Report FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Landscape FORMTEXT ?????4520Conduct Contamination Site Investigation (Intial Sampling) FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMTEXT ?????4540Conduct Remedial Investigation (Delineation Sampling) FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMCHECKBOX LSRP FORMTEXT ?????4550Develop Cultural Resources Mitigation Measures FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Landscape FORMCHECKBOX Designer FORMCHECKBOX DPM FORMTEXT ?????4570Prepare Material Management Plan FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMCHECKBOX LSRP FORMTEXT ?????4585Complete Environmental Plans FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMTEXT ?????4590Prepare PAECE Report FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX Designer FORMTEXT ?????4645Obtain ROW Environmental Reevaluation FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMTEXT ?????4720Prepare Green Acres Pre-Application FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMTEXT ?????4725Owner Submits Green Acres Pre-Application FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Owner FORMCHECKBOX Environmental FORMTEXT ?????4730Obtain Resolution of Support for Green Acres Pre-Application FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Owner FORMCHECKBOX Environmental FORMTEXT ?????4735NJDEP Reviews Green Acres Pre-Application FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DEP (Green Acres) FORMTEXT ?????4740Prepare Green Acres Final Application FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMTEXT ?????4745Owner Submits Green Acres Final Application FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Owner FORMCHECKBOX Environmental FORMTEXT ?????4750Hold Green Acres Public Hearing FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX DPM FORMCHECKBOX Owner FORMCHECKBOX Comm. Relations FORMTEXT ?????4755Obtain Resolution of Support for Green Acres Final Application FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Owner FORMCHECKBOX Environmental FORMTEXT ?????4760Submit Green Acres Final Application Supplemental Information FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Owner FORMCHECKBOX Environmental FORMTEXT ?????4765NJDEP Reviews Green Acres Final Application FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DEP (Green Acres) FORMTEXT ?????4770Obtain State House Commission Approval FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DEP (Green Acres) FORMCHECKBOX State House Comm FORMTEXT ?????4775Acquire Green Acres Parcels FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX ROW FORMCHECKBOX DAG FORMCHECKBOX DPM FORMTEXT ?????4780Obtain Green Acres Compensation Appraisal FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMCHECKBOX DAG FORMCHECKBOX ROW FORMCHECKBOX DPM FORMTEXT ?????4850Certify Soil Erosion and Sediment Control FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMTEXT ?????4860Obtain Construction Environmental Reevaluation FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Environmental FORMTEXT ?????Environmental Document: FORMCHECKBOX CED FORMCHECKBOX CCED FORMCHECKBOX EA FORMCHECKBOX EIS FORMCHECKBOX EO 215 Approval Date: FORMTEXT ?????Total Number of Permits: FORMTEXT ????? List any environmental impacts and/or issues: FORMTEXT ????? List any environmental commitments (made in approved environmental documents, through Memoranda of Agreement with environmental agencies, other commitments made to the public, local officials or other government agencies) such as 4f, Section 106 (historic architecture, archaeology), air, noise, hazardous waste and ecology: FORMTEXT ????? List commitments that other units must fulfill in the Summary of Commitments table in Section 1 above.Check the environmental clearances or permits required on the project:Federal FORMCHECKBOX U.S. Coast Guard (Bridge) FORMCHECKBOX USACOE Section 10 (Navigable Waters) FORMCHECKBOX USDOA Forms AS-1006 FORMCHECKBOX USACOE Section 404 (Individual/Nationwide) discharge of fill FORMCHECKBOX USACOE Section 9 (Dam or Dike) FORMCHECKBOX National (or State) Wild & Scenic Rivers FORMCHECKBOX Section 7 Endangered Species Consultation FORMCHECKBOX NMFS Essential Fish Habitat StudyState FORMCHECKBOX CAFRA FORMCHECKBOX Hazardous Waste Site Investigation (SI/RI) FORMCHECKBOX NJDEP Tidal Wetlands FORMCHECKBOX NJDEP Pollutant Discharge FORMCHECKBOX NJDEP Water Lowering FORMCHECKBOX HazWaste Remedial Action Work plan FORMCHECKBOX NJDEP Waterfront Development FORMCHECKBOX NJDEP Flood Hazard Area FORMCHECKBOX NJDEP Riparian FORMCHECKBOX NJDEP Sanitary Facilities FORMCHECKBOX NJDEP Freshwater Wetlands FORMCHECKBOX NJDEP Water Quality Certificate FORMCHECKBOX NJDEP NJPDES Stormwater Construction GP (RFA)Other FORMCHECKBOX Delaware River Basin Commission FORMCHECKBOX Hackensack Meadowlands Commission FORMCHECKBOX Highlands Commission FORMCHECKBOX Delaware & Raritan Canal Commission FORMCHECKBOX Pinelands Commission FORMCHECKBOX State Agriculture Development CommissionADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments that other units must fulfill in the Summary of Commitments in Section 1 above.Examples of information for this section include any additional information related to permits anticipated, anticipated environmental impacts and environmental commitments made in any of the previous phases, etc. 82555461000 FORMTEXT ?????Value EngineeringActivity No.Activity NameExecuteResponsible UnitComments FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Yes FORMCHECKBOX No FORMTEXT ????? FORMTEXT ?????Total Estimated Cost including Construction, ROW and Utilities: FORMCHECKBOX $1-10 million FORMCHECKBOX $10-20 million FORMCHECKBOX $20-$40 million FORMCHECKBOX >$40 millionValue Engineering Analysis Performed? FORMCHECKBOX Yes FORMCHECKBOX NoADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.Examples of information for this section include Value Engineering Analysis, and Cost information06096000 FORMTEXT ?????UtilitiesActivity No.Activity NameExecuteResponsible UnitComments4035Determine Utility Master Agreement Applicability FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMCHECKBOX Utilities FORMCHECKBOX Utility Companies FORMTEXT ?????4040Prepare Utility Master Agreement Change Order FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Utilities FORMTEXT ?????4045Execute Utility Master Agreement Change Order FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Utilities FORMTEXT ?????4050Develop Alternatives of Accommodation FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMCHECKBOX Utility Companies FORMTEXT ?????4085Conduct Supplemental Subsurface Utility Engineering FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMCHECKBOX Utility Companies FORMTEXT ?????4055Prepare Utility Owner Design Authorization Checklist FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Utility Companies FORMCHECKBOX DPM FORMCHECKBOX Designer FORMTEXT ?????4060Prepare Utility Agreement Plans, Specifications and Estimates FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX Utility Companies FORMTEXT ?????4065Approve Utility Agreement Plans, Specifications and Estimates FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMTEXT ?????4070Prepare Utility Agreement Modifications FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMTEXT ?????4080Authorize Utility Work FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMCHECKBOX Program Coord. FORMTEXT ?????4085Conduct Supplemental Subsurface Utility Engineering FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX SUE Contractor FORMCHECKBOX Utility Companies FORMTEXT ?????4090Incorporate Utility Design in Contract Documents FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMTEXT ?????Total Number of Utility Companies: FORMTEXT ?????Utility TypeUtility CompanySize (Units of Measure)Location (aerial/underground)Gas FORMTEXT ????? FORMTEXT ????? Pipe FORMTEXT ?????Electric FORMTEXT ????? FORMTEXT ????? Volts FORMTEXT ?????Cable FORMTEXT ????? FORMTEXT ????? Pairs/ Strands FORMTEXT ?????Telephone FORMTEXT ????? FORMTEXT ????? Pairs/ Strands FORMTEXT ?????Water FORMTEXT ????? FORMTEXT ????? Pipe FORMTEXT ?????Sewer FORMTEXT ????? FORMTEXT ????? Pipe FORMTEXT ?????Fiber-Optic (non-Department) FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????NJDOT ITS Utilities FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Other: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Other: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Other: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????1. Identify if the Utility Discovery and Verification requires subsurface utility exploration: FORMTEXT ?????2. Is a SUE (Subsurface Utility Exploration) Consultant required? FORMCHECKBOX Yes FORMCHECKBOX No3. Identify Potential Conflicts: FORMTEXT ?????4. Identify Temporary Relocations that are needed during construction: FORMTEXT ?????5. Number of poles? FORMTEXT ????? 6. Number of guy wires on existing poles? FORMTEXT ????? 7. Are there cell towers or substations? FORMTEXT ????? Can utility relocations be avoided or performed in advance of the project? FORMTEXT ????? Can utility design/construction be performed by designer/contractor? FORMTEXT ????? Can ROW needed for utilities be identified? FORMTEXT ????? Will guying rights be obtained by the utility owner, if outside the State ROW? FORMTEXT ????? List any known seasonal restrictions to working on the utility facilities (e.g., electric transmission in summer). FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments that other units must fulfill in the Summary of Commitments in Section 1 above.Examples of information for this section include location of cell towers, location/presence of fiber optic lines, etc.06096000 FORMTEXT ?????JurisdictionActivity No.Activity NameExecuteResponsible UnitComments4100Prepare Jurisdicitional Limit Maps and Agreements FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX DPM FORMCHECKBOX DAG FORMTEXT ?????4105Execute Jurisdictional Agreements FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Various Agencies FORMTEXT ?????Total number of maps: FORMTEXT ????? Total number of agreements: FORMTEXT ?????Are there streetscape or aesthetic items intended for this project? FORMCHECKBOX Yes FORMCHECKBOX NoIf yes, has a resolution of support been acquired for jurisdictional assignment? FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX NAADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments in the Summary of Commitments in Section 1 above.An example of information for this section: details of a local approval.06096000 FORMTEXT ?????Geometrics & RoadwayActivity No.Activity NameExecuteResponsible UnitComments4210Complete Horizontal / Vertical Geometry FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMTEXT ?????4220Prepare Final Roadway Plans FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMTEXT ?????Construction Plans/Estimated Number of Sheets Roadway and Bridges FORMTEXT ?????Key Map FORMTEXT ?????Grades FORMTEXT ?????Method of Cross Sections FORMTEXT ?????Estimate-Distribution of Quantities FORMTEXT ?????Traffic Control and Staging Plans FORMTEXT ?????Cross Sections FORMTEXT ?????Typical Sections FORMTEXT ?????Traffic Control Plans FORMTEXT ?????Alternate Retaining Wall System FORMTEXT ?????Plan Sheet Index FORMTEXT ?????ITS Plans FORMTEXT ?????Estimate of Quantities – Bridge FORMTEXT ?????Construction Plans FORMTEXT ?????Electrical Details FORMTEXT ?????Earthwork Summary FORMTEXT ?????Drainage Plans FORMTEXT ?????Traffic Signal Plans FORMTEXT ?????Structural Plans FORMTEXT ?????Environmental Plans FORMTEXT ?????Highway Lighting Plans FORMTEXT ?????Earthwork Chart Sheet FORMTEXT ?????Profiles FORMTEXT ?????Landscape Plans FORMTEXT ?????Non-standard Roadway Construction Details FORMTEXT ?????Ties FORMTEXT ?????Traffic Signing and Striping Plans FORMTEXT ?????Non-standard Bridge Construction Details FORMTEXT ?????Construction DetailsRight of Way Documents FORMTEXT ?????Entire Tract Map FORMTEXT ?????Tabulation Sheets FORMTEXT ?????Individual Property Maps (IPM) FORMTEXT ?????General Property Parcel Maps FORMTEXT ?????Parcel Descriptions FORMTEXT ?????Alignment SheetsOther Documents FORMTEXT ?????Jurisdictional Maps FORMTEXT ?????Utility Agreements Plans FORMTEXT ?????Railroad Crossing Element Plans FORMTEXT ?????Project specific Specifications FORMTEXT ?????Utility PlansAre there any additional documents? FORMCHECKBOX Yes FORMCHECKBOX NoPlease identify any additional documents: FORMTEXT ?????1. Existing Roadway(s):Roadway No. 1Roadway No. 2Roadway No. 3Roadway No. 4Roadway Name: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Posted Speed(s): FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Highway Classification: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Significance (local or regional): FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????No. of Interchanges: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Traffic Volumes: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Design Speeds: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Development Class: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????No. of Traffic Signals: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????No. of Intersections: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????2. Typical Section(s):Typical Section No. 1Typical Section No. 2Typical Section No. 3Typical Section No. 4Right of Way Width: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Number of Lanes: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Lane width & cross slope: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Shoulder width & cross slope: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Median width: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Sidewalk/border width: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Median description and the overall roadway width: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????3. Intersection/Interchange (describe the existing intersections and/or interchanges including turning and auxiliary lanes.): FORMTEXT ?????4. Existing Deficiencies (provide an overview of the existing deficiencies. Geometric: Substandard horizontal and vertical sight distance, insufficient sight triangle, substandard vertical clearance, substandard or no shoulders, acceleration, deceleration lanes, etc. Safety Issues: Check crash data for indicators of specific problems. Substandard/nonexistent guiderail, attenuators, pavement condition, skid resistance, median, etc.). Note on substandard guiderail: the project limits should be extended to include upgrading any existing substandard guiderail run that extends beyond the proposed work limits as required by the Design Manual. FORMTEXT ?????5. Proposed Improvements (provide a brief narrative of the proposed improvements and how they address the identified deficiencies. Note changes to be made to profiles, alignment, guiderail, and typical section): FORMTEXT ?????6. Bicycle/Pedestrian Compatible? FORMCHECKBOX Yes FORMCHECKBOX NoIf no, please explain: FORMTEXT ?????7. List any commitments made to the public, local officials or other government agencies in the Summary of Commitments table in Section 1 above. ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments that other units must fulfill in the Summary of Commitments in Section 1 above.Examples of information for this section include a discussion of substandard design elements, design exceptions, perhaps a quick description of the proposed geometry if it is unusual, and commitments made to the community, etc.06096000 FORMTEXT ?????PavementActivity No.Activity NameExecuteResponsible UnitComments4205Verify Pavement Design Recommendation FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX Pavement FORMTEXT ?????4295Obtain Pavement Specifications FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX Pavement FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments in the Summary of Commitments in Section 1 above.Examples of information for this section include evidence of subsurface drainage issues, settlement problems, stability problems, etc. 06096000 FORMTEXT ?????Structures Activity No.Activity NameExecuteResponsible UnitComments4175Prepare Noise Barrier Details FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX Landscape FORMTEXT ?????4160Prepare Final Structures Documents FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX H&H FORMCHECKBOX Structures FORMTEXT ?????4315Complete Final Bridge Analysis FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX H&H FORMCHECKBOX Structures FORMTEXT ?????Total Number of New Bridges: FORMTEXT ?????Total Number of New Spans: FORMTEXT ?????Total Number of Rehab Bridges: FORMTEXT ?????Total Number of Rehab Spans: FORMTEXT ?????Total Number of Replacement Bridges: FORMTEXT ?????Total Number of Replacement Spans: FORMTEXT ?????1. Condition of existing bridge(s):Bridge No. 1Bridge No. 2Bridge No. 3Bridge No. 4a. NJDOT Structure Number: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????b. Year Built: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????c. Date/type of any major modifications: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????d. Type & material of superstructure: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????e. Type and material of substructure: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????f. Feature that is spanned: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????g. Type of roadway it carries: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????h. Vertical Clearance of structure: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????i. Number of Spans: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????j. Length of Structure: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????k. Width of Structure: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????l. Horizontal Clearance of the pier / abutment with respect to the riding lane: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????m. Typical Section (number of lanes, width and cross slope, shoulders and width of each sidewalk): FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????n. Parapet railing type: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????o. Existing aesthetic/historical architectural treatments: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????p. Identify the structural deficiencies: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????q. Bridges over waterways: Identify scouring evaluation, bridge opening capacity, and frequency of storm, etc. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????2. Proposed Bridge(s)/Bridge Improvements:Bridge No. 1Bridge No. 2Bridge No. 3Bridge No. 4a. Number of spans: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????b. Identify the type of maintenance of traffic that will be used (staging or detour): FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????c. Identify the changes to the typical section of the existing structure: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????d. Number of Spans: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????e. Vertical Clearance of structure:: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????f. Length of Structure: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????g. Width of Structure: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????h. Type & material of superstructure: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????i. Type and material of substructure: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????j. Horizontal Clearance of the pier/abutment with respect to the riding lane: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????k. Typical Section (number of lanes, width and cross slope, shoulders and width of each sidewalk): FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????l. Parapet railing type: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????m. Existing aesthetic/historical architectural treatments: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????n. Identify the structural deficiencies: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????o. Coast Guard Permit Required: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????3. Are the minimum vertical clearance requirements over waterways, roadways, railroads met? FORMCHECKBOX Yes FORMCHECKBOX No If no, please explain? FORMTEXT ?????4. List other substandard features of proposed bridge: FORMTEXT ?????5. Other Existing Structure(s): 5a. Identify existing minor structures (Noise barriers, Retaining Walls (cast in place or alternate system), Gabions, High Tower Lighting foundations, Pre-cast Culverts, Culvert extensions, Type and number of Overhead Sign Structures): FORMTEXT ?????5b. Specify type and number of each substandard feature: FORMTEXT ?????6. If there is a deck replacement: Has a site inspection been completed by Structures personnel FORMCHECKBOX Yes Date: FORMTEXT ????? FORMCHECKBOX NoHas a bridge inspection report which is less than two years old been reviewed? FORMCHECKBOX Yes Date of inspection report: FORMTEXT ????? FORMCHECKBOX No.State reasons to justify that the superstructure is not being replaced: FORMTEXT ?????7. Proposed Other Structure(s): Structure No. 1Structure No. 2Structure No. 3Structure No. 4a. Identify changes in the existing minor structure that are being improved: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????b. List substandard features to be included in the design exception: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????c. Length: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????d. Width: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????e. Number of spans/units: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments in the Summary of Commitments in Section 1 above.Examples of information for this section include scour, unusual existing or proposed structural elements, clearances, substandard elements, design exceptions, etc.06096000 FORMTEXT ?????GeotechnicalActivity No.Activity NameExecuteResponsible UnitComments4300Develop Subsurface Exploration Program FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Geotech FORMCHECKBOX Designer FORMTEXT ?????4305Gather Subsurface Information FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Geotech FORMCHECKBOX Designer FORMCHECKBOX Contractor FORMTEXT ?????4320Conduct Geotechnical Foundation, Roadway and Rock Slope Design FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Geotech FORMCHECKBOX Designer FORMTEXT ?????Is there evidence of subsurface drainage problems? FORMTEXT ?????Is there evidence of settlement problems? FORMTEXT ?????Is there evidence of stability problems? FORMTEXT ?????Is there evidence of scour problems? FORMTEXT ?????Are there existing soil-borings within the project limits? FORMTEXT ?????Are there rock slopes/cuts located within the project limits? FORMTEXT ?????Are there rock cuts listed in the Rockfall Hazard Rating System? FORMTEXT ?????Do catchment areas need to be cleaned or modified? FORMTEXT ?????Are there apparent safety problems with protruding rock, sight lines, rock-fall, and substandard existing mitigation measure? FORMTEXT ?????Alternate site exploration (test pits)? FORMTEXT ?????Is a foundation report required? FORMCHECKBOX Yes FORMCHECKBOX NoList any existing or proposed structures that may be impacted by construction activities such as vibration, settlement, or noise: Structure: FORMTEXT ????? impacted by: FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments that other units must fulfill in the Summary of Commitments in Section 1 above.Examples of information for this section include rock slope issues, soil borings, scour, unusual existing or proposed structural elements, clearances, etc.06096000 FORMTEXT ?????SurveyActivity No.Activity NameExecuteResponsible UnitComments4215Conduct Supplemental Surveys FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX Survey FORMTEXT ?????Identify available mapping information (aerial/conventional methods/ 3-D surface models): FORMTEXT ?????How were the existing and proposed baselines established? FORMTEXT ?????How were the existing and proposed ROW lines established? FORMTEXT ?????How was the horizontal and vertical control established and which existing monumentation was used? FORMTEXT ????? Is project in Tidal area? FORMCHECKBOX Yes FORMCHECKBOX No If yes, then current mean high water elevation must be established in tidal water areas under Tidelands Bureau jurisdiction. FORMTEXT ?????Has NJDOT Regional Survey office been contacted regarding existing Control, and as built plans within the project area? FORMTEXT ?????Is compliance with MAP filing law required? FORMCHECKBOX Yes FORMCHECKBOX NoHas NJDOT Geodetic Survey been contacted regarding existing control within the project? FORMCHECKBOX Yes FORMCHECKBOX NoDoes Primary Control exist within the project limits or immediately adjacent to the project? FORMCHECKBOX Yes FORMCHECKBOX NoIf yes, what year was control established in? FORMTEXT ?????If no, will primary control be required? FORMTEXT ?????Will plans be developed from aerial photogrammetry or as-built plans and conventional survey? FORMTEXT ?????Geodetic Survey Services will be provided by: FORMCHECKBOX In-House FORMCHECKBOX ConsultantADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.Examples of information for this section include base mapping obtained during PE or earlier, tidal issues, compliance with MAP filing laws, geodetic control issues, etc.06096000 FORMTEXT ?????RailroadsActivity No.Activity NameExecuteResponsible UnitComments4110Prepare Railroad 60% Submission FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Railroads FORMCHECKBOX Designer FORMTEXT ?????4115Address Railroad 60% Comments FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Railroad Co. FORMCHECKBOX Utilities FORMCHECKBOX Designer FORMTEXT ?????4120Prepare Railroad 100% Submission FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Railroads FORMCHECKBOX Designer FORMTEXT ?????4125Review Railroad 100% Submission FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Railroad Company FORMTEXT ?????4130Revisit Railroad Diagnostic Team Meeting FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Railroads FORMTEXT ?????Railroads Affected FORMDROPDOWN FORMDROPDOWN FORMDROPDOWN FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Grade Crossings Affected? FORMCHECKBOX Yes FORMCHECKBOX No How many? FORMTEXT ?????Is there sufficient overhead structure clearance? FORMCHECKBOX Yes FORMCHECKBOX NoDiagnostic Team Meeting Required: FORMCHECKBOX Yes FORMCHECKBOX NoDiagnostic Team Meeting Held: FORMTEXT ????? (DATE)ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments in the Summary of Commitments in Section 1 above.Examples of information for this section include presence of at-grade crossings, overhead structure clearances, diagnostic team meetings, etc.06096000 FORMTEXT ?????Construction & Risk AnalysisActivity No.Activity NameExecuteResponsible UnitComments4225Conduct Final Design Constructability-Risk Analysis Workshop FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX Construction FORMTEXT ?????4275Develop Construction Cost Estimate FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX Construction FORMTEXT ?????4280Develop Specifications FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX Construction FORMTEXT ?????4285Develop Construction Schedule FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX Construction FORMTEXT ?????List any commitments made to the public, local officials or other government agencies: FORMTEXT ?????Traffic Staging: How many lanes of traffic need to be maintained? FORMTEXT ????? What will be the available working hours? FORMTEXT ????? Can the project duration be significantly reduced by reducing the number of stages? FORMTEXT ????? Can detours be used? FORMTEXT ????? Provide a brief summary of the proposed staging. FORMTEXT ?????Schedule: Identify scheduling constraints (environmental, seasonal construction limitations, community). FORMTEXT ????? What is the optimum period to start construction? FORMTEXT ????? Utilities: Can utility relocations be avoided or performed in advance of the project? FORMTEXT ????? Can utility design/construction be performed by designer/contractor? FORMTEXT ????? Can ROW needed for utilities be identified? FORMTEXT ????? Is the scope focused on replacement or rehabilitation of road/bridge? FORMTEXT ????? Is condition likely to change/deteriorate between scoping and construction? FORMTEXT ?????Risk Analysis to be preformed? FORMCHECKBOX Yes FORMCHECKBOX NoLane Miles: (Lane Miles = Length of Road * Number of Lanes) (Shoulders are not included in these calculations.)Lane Miles for:NewRehabilitationInterstate Highway FORMTEXT ????? FORMTEXT ?????State Routes FORMTEXT ????? FORMTEXT ?????Primary Routes FORMTEXT ????? FORMTEXT ?????County Routes FORMTEXT ????? FORMTEXT ?????Side Streets FORMTEXT ????? FORMTEXT ?????All Ramps FORMTEXT ????? FORMTEXT ?????Total Number of Bridges: FORMTEXT ????? Total new bridge span lanes (width is in feet): Bridge Span Lanes = (Width * #Spans) / 12’ FORMTEXT ?????Total superstructure replacement span lanes (width is in feet): Bridge Span Lanes = (Width * #Spans) / 12’ FORMTEXT ?????Total culvert span lanes (width is in feet): Culvert Span Lanes = Width / 12’ FORMTEXT ?????Total square feet of retaining walls: FORMTEXT ?????Total square feet of noise walls: FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments in the Summary of Commitments in Section 1 above.Examples of information for this section include commitments made to local officials or other agencies, staging details, detour discussion, schedule constraints, utility conflicts, etc.06096000 FORMTEXT ?????Traffic EngineeringActivity No.Activity NameExecuteResponsible UnitComments4230Complete Lighting Design FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX TSSE FORMCHECKBOX Designer FORMTEXT ?????4240Complete Traffic Signal, Signing and Striping Plans FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX TSSE FORMCHECKBOX Designer FORMTEXT ?????Number of New Traffic Signals: FORMTEXT ?????Number of Revised Traffic Signals: FORMTEXT ?????New overhead signs and sign structures FORMCHECKBOX Yes FORMCHECKBOX NoRevised overhead signs and sign structures FORMCHECKBOX Yes FORMCHECKBOX NoNew Guide Signs FORMCHECKBOX Yes FORMCHECKBOX NoRevised Guide Signs FORMCHECKBOX Yes FORMCHECKBOX NoNumber of Roundabouts FORMTEXT ?????Signal pre-emption (Rail/Movable Bridge/emergency vehicles/etc.) FORMCHECKBOX Yes FORMCHECKBOX NoRevised Highway Lighting FORMCHECKBOX Yes FORMCHECKBOX NoTemporary Lighting for staging or diversion roadways FORMCHECKBOX Yes FORMCHECKBOX NoRaised Pavement Markers FORMCHECKBOX Yes FORMCHECKBOX No1. What type of maintenance of traffic will be used during construction (i.e., staging, detour, permanent lane closures, or diversion road): FORMTEXT ?????2. Identify the number and location of temporary traffic signal(s) required during Staging or Detours: FORMTEXT ?????3. Is there adequate corner ROW cutout for signal equipment installation? FORMCHECKBOX Yes FORMCHECKBOX No4. Identify if a new or revised traffic signal agreement is required? FORMTEXT ?????5. Identify overhead utility conflicts for traffic signals to be identified and resolved: FORMTEXT ?????6. Is current traffic count data and analysis available? (If so provide year of data.): FORMTEXT ?????For new traffic signals, are the signal warrants met? (provide year it meets): FORMTEXT ?????For existing traffic signals, are the current TS and Electrical plans available in MicroStation format? FORMTEXT ????? filename: FORMTEXT ????? Is the existing or proposed signal interconnected to other signals, time based coordination or an isolated intersection? FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments in the Summary of Commitments in Section 1 above.Examples of information for this section include discussion of need for temporary signals, right of way constraints (related to traffic signal equipment), utility conflicts, etc.06096000 FORMTEXT ?????Electrical MaintenanceActivity No.Activity NameExecuteResponsible UnitComments FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Yes FORMCHECKBOX No FORMTEXT ????? FORMTEXT ?????Do any elements of this project scope include new roadway / electrical appurtenances that would require specialized training, equipment or materials to properly maintain the item (e.g., ornamental lighting)? FORMCHECKBOX Yes FORMCHECKBOX NoIf yes, provide details: FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments in the Summary of Commitments in Section 1 above.Examples of information for this section include elements of the design that will necessitate an increase in maintenance personnel or equipment, etc.06096000 FORMTEXT ?????Maintenance and OperationsActivity No.Activity NameExecuteResponsible UnitComments FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Yes FORMCHECKBOX No FORMTEXT ????? FORMTEXT ?????1. Regional Maintenance has been consulted for needs and impacts? FORMCHECKBOX Yes FORMCHECKBOX No Identify needs and impacts. FORMTEXT ?????Maintenance agrees with the scope, and impact of the project: FORMCHECKBOX Yes FORMCHECKBOX No Comments: FORMTEXT ?????2. Operations Support has been consulted for needs and impacts? FORMCHECKBOX Yes FORMCHECKBOX No Identify needs and impacts. FORMTEXT ?????3. Do any elements of this project scope require additional planned maintenance activities that would necessitate an increase in personnel or equipment resources? FORMCHECKBOX Yes FORMCHECKBOX No If yes, provide details: FORMTEXT ?????4. Do any elements of this project scope include new roadway / electrical appurtenances that would require specialized training, equipment or materials to properly maintain the item (e.g., Vortech drainage chamber, ornamental lighting, brick pavers)? FORMCHECKBOX Yes FORMCHECKBOX NoIf yes, provide details: FORMTEXT ?????Does this project scope include or overlap sections of roadway that are simultaneously being planned or scheduled for Operations maintenance/construction activities? FORMCHECKBOX Yes FORMCHECKBOX No If yes, provide details: FORMTEXT ?????Should consideration be given to canceling or postponing the Operations activity? FORMCHECKBOX Yes FORMCHECKBOX No If yes, provide details: FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments in the Summary of Commitments in Section 1 above.Examples of information for this section include maintenance repairs, operational issues, simple safety improvements, etc.06096000 FORMTEXT ?????Traffic Operations and Intelligent Transportation System (ITS) EngineeringActivity No.Activity NameExecuteResponsible UnitComments4235Complete Final Design Systems Engineering Review Form FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX ITS FORMCHECKBOX Traffic Ops FORMTEXT ?????4250Prepare ITS Facilities Layout Plan FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX ITS FORMCHECKBOX Traffic Ops FORMTEXT ?????4255Complete ITS Facililties Plans FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Designer FORMCHECKBOX ITS FORMCHECKBOX Traffic Ops FORMTEXT ?????1. Project scope complies with the requirements of the latest ITS Investment Strategy and ITS Architecture? FORMCHECKBOX Yes FORMCHECKBOX No2. Traffic Operations (North / South) has been consulted for needs and impacts? FORMCHECKBOX Yes FORMCHECKBOX No Identify needs and impacts. FORMTEXT ?????3. Transportation Data Development has been consulted for needs and impacts? FORMCHECKBOX Yes FORMCHECKBOX NoIdentify needs and impacts. FORMTEXT ?????4. Project limits have been visually inspected for the existing ITS facilities? FORMCHECKBOX Yes FORMCHECKBOX No5. Check if the project includes the construction or relocation of any of the following Intelligent Transportation System (ITS) facilities: FORMCHECKBOX Controlled Traffic Signal Systems (CTSS) FORMCHECKBOX Dynamic Message Signs (DMS) FORMCHECKBOX Traffic Detection systems FORMCHECKBOX Weigh-in-Motion (WIM) FORMCHECKBOX Roadway Weather Information Systems (RWIS) FORMCHECKBOX Fiber Optic Conduit and/or Cable FORMCHECKBOX Closed Circuit TV Cameras (CCTV) FORMCHECKBOX Highway Advisory Radio (HAR) FORMCHECKBOX Bridge Sensors FORMCHECKBOX Traffic Volume Stations FORMCHECKBOX In-Road Sensors FORMCHECKBOX Electrical or Communication Installations for the above systems FORMCHECKBOX Other ITS Devices: FORMTEXT ?????6. Check if real time work zone ITS Systems are to be deployed during construction: FORMCHECKBOX Travel Time FORMCHECKBOX Queue Detection FORMCHECKBOX Dynamic Merge FORMCHECKBOX Traffic Cameras FORMCHECKBOX Variable Speed Limit or Advisory FORMCHECKBOX Other FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments in the Summary of Commitments in Section 1 above.Examples of information for this section include compliance with latest ITS Investment Strategy and Architecture, consultation with Traffic Ops during CD or PE, etc.06096000 FORMTEXT ?????Commuter MobilityActivity No.Activity NameExecuteResponsible UnitComments FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Yes FORMCHECKBOX No FORMTEXT ????? FORMTEXT ?????Has NJ Transit or other affected bus companies been contacted? FORMTEXT ????? (NJ Transit has strongly expressed their desire to be “in the loop” early and again during construction.)ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Please be clear and concise. Provide your unit's contact person and number.List any commitments in the Summary of Commitments in Section 1 above.Examples of information for this section include bicycle and pedestrian compatibility, Complete Streets compliance, presence of bus stops, interruption of pedestrian accommodations during construction, ADA issues, etc.06096000 FORMTEXT ?????Technical and Administrative ActivitiesActivity No.Activity NameExecuteResponsible UnitComments4010Intiate FD FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMTEXT ?????4290Prepare Final Design Submission Package FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMTEXT ?????4785Prepare Financial Plan (Major Projects) FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMTEXT ?????4790Update Project Management Plan (Major Projects) FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX FHWA FORMCHECKBOX SMEs FORMCHECKBOX Designer FORMTEXT ?????4795Execute Final Design Public Involvement Action Plan FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX DAG FORMCHECKBOX Comm. Relations FORMTEXT ?????4805FHWA Reviews Final Design Submission FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX FHWA FORMTEXT ?????4815Finalize Specifications for Comptroller Approval (Projects >$10M) FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMCHECKBOX Construction FORMTEXT ?????4855Confirm Need for Traffic Regulation Orders FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMCHECKBOX TSSE FORMTEXT ?????4825Comptroller Approves Specifications (Projects >$10M) FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX State Comptroller FORMTEXT ?????4830Resolve Final Design Submission Comments FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMTEXT ?????4835Prepare Pre-PS&E Package FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMTEXT ?????4840Submit PS&E Package FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMTEXT ?????4845FHWA Reviews Pre-PS&E FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX FHWA FORMTEXT ?????4865Execute Consultant Agreement Addendum (CAA) FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMTEXT ?????4875Prepare Advertising Authorization Package FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX CM FORMCHECKBOX EDU FORMCHECKBOX FHWA FORMCHECKBOX Designer FORMCHECKBOX Prog Coordination FORMTEXT ?????4885Receive Authorization to Advertise FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX CM FORMCHECKBOX FHWA FORMCHECKBOX Prog Coordination FORMTEXT ?????4895Complete FD Closeout FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX DPM FORMCHECKBOX Designer FORMTEXT ?????1. Have the objectives of the Public Involvement Action Plan (PIAP) been satisfied: FORMCHECKBOX Yes FORMCHECKBOX No2. Number of Local Workshop Meetings conducted in PE: FORMTEXT ?????3. Public Information Centers conducted in PE (number of meetings, location & dates): FORMTEXT ?????4. Number of Officials Briefings conducted in PE: FORMTEXT ?????5. List Issues, Commitments or Concerns: FORMTEXT ?????6. Is the mailing list up to date? FORMCHECKBOX Yes FORMCHECKBOX No7. Are the Displays adequate to reuse in FD: FORMCHECKBOX Yes FORMCHECKBOX No8. Resolution of Support Number: FORMTEXT ?????Resolution of Support Date: FORMTEXT ?????9. Other Coordination:a. List additional organizations (e.g., Historic Society, Chamber of Commerce, Board of Education, Fire Company’s etc.) or authorities (NJ Transit, NJ Turnpike, NJ Highway Authority, Port Authority, etc.) that have interest in the project: FORMTEXT ?????b. Proposed Formal Public Involvement Program (estimate number of Official Briefings and Public Info Centers/Meetings/Hearings): FORMTEXT ?????c. If additional displays are required, provide the specifics (number, scale, special graphics 3D, simulations, models, etc): FORMTEXT ?????d. If a mailing list is required, provide the approximate number of property owners: FORMTEXT ????? Who is responsible for putting the mailing list together and providing mail labels? FORMCHECKBOX Consultant FORMCHECKBOX In-house Design FORMCHECKBOX Other (Specify) FORMTEXT ????? e. If handouts are required (provide the specifics, number, size, color or black and white, mapping, etc): FORMTEXT ?????f. List special needs (e.g., Community Involvement Sub-Consultant, Facility Needs, Interpreter, Website, etc.): FORMTEXT ?????ADDITIONAL INPUTThis section has been provided for the PE designer and the functional units to state any assumptions, to clarify and customize standard activities, and to add important information. Include any commitments made to the community or outside agencies including NJDEP in Section 1 above. Please be clear and concise. Provide your unit's contact person and number. 06096000 FORMTEXT ?????Summary of ApprovalsSME UnitManagerApprovalSME InvolvedRemarksRight of Way FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Access FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Drainage FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Landscape FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Environmental FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Value Engineering FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Utilities FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Jurisdiction FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Geometrics & Roadway FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Pavement FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Structures FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Geotechnical FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Survey FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Railroads FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Construction & Risk Analysis FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Traffic Engineering FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Electrical Maintenance FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Maintenance and Operations FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Traffic Operations & ITS FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Commuter Mobility FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? ................
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