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SIGN STRUCTURE Inspection Type

Routine
CONDITION INSPECTION Detailed

Structure Structure Inspection Date


Number Name (yyyy/mm/dd)

COMPONENT PERCENT CONDITION RATING INSPECTION NOTES BY COMPONENT


Enter % in each condition. All poor or very poor conditions must be expired.
See BMIS User Manual 15.2.4 Label explanation(s) with component numbers.

FOUNDATION E G F P V X N
1 Anchor Bolts
2 Base Plate(s)
3 Bracing
4 Connections
5 Coating
6 Foundation(s)
7 Main Chords/Poles
8 Traffic Barriers
9 Walkway Support
10 Handrail/Safety Line

General Inspection Notes:

Urgency Rating Notes:

Electrical Concersn (Contact Regional Electrician):

Sign Concerns (Contact Area Manager Roads):

Condition Codes Urgency Rating


E Excellent V Very Poor
G Good X Not Inspected
F Fair N Not Applicable
P Poor For definition, see
For Condition Guidelines see BMIS User Manual
BMIS User Manual 15.2.2. 15.2.8. "4" and
"5" rating must be
explained.

Inspection (please type or print) Signature


Side 1 of 2
Structure Number

Sign Message

Posted Hazard Warning Signs

Area Description

Rehab Work Notes:

Maintenance Work Notes:

Side 2 of 2