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<br />
<br />U.S. COT CROSSING INVENTORY FORM
<br />
<br />DI!PARTMI!NT 0' TRANS"OR1'ATlON
<br />
<br />F~PIiRI\l, R~/lReAQ AaMIN/lim.A7fQN (FRAt OMS No. 2130..0017
<br />A. Initialing AUllney ar"~1I11111 p, CrClslilng Number (mllx, 7 ehs'.1 I C. l'111lllsan (or UpQa11l 1;), if/ecll\l" Oi\lq
<br />ORllllrllllel 0'\ \ Gl ~ ~ y Ci!1hllnGU In 0 NIIW ercli,~lng Cl CloPD" Crllsslng (MMIOO/Y'1Tl
<br />. existing Olllll or Abllndcmlld o'b \ l ~ 0 ~
<br /> Port I: LCllllltllln IInd Qlanlnllllllon Informatllln
<br />1. RlltlrCllld Op\lr, Ca. (eoelo (mall. '/ char) ar nllme) 2, Stllta (2 ahar.) 3. Co~nly (mIll 20 char,)
<br /> 'SCO MN 'Do-'t-(Sta..
<br />4, RailrQlld Division or Region (max, 14 aIJar,) 5. Rallrcllld Subdivision or Olstrlct(max, 14ahsr.) e, Branch or LinD Nllme (max. '1 il ahar.) 7, RR Milepost (max. r char.)
<br />~ Po.W \ '5e\\J iG R \ \j-e.>(' Mo.l~ IMBnn,nnl
<br /> O~9\ 0';
<br />e, RR I.e. No. (max. 'fO ahlT.) 9. Neerest RR Tlmlllable Stallon (max. 1S char.) 10, I'arant RR (max. 4 ahar.) 11. Crossing Owner (RR ar Company name)
<br />(opl/onel) t1a.st\ n.'15 (II appllcablo) (If applicable)
<br /> ~p~
<br />12, Clly (maxdl-tar.) 13. Street or Road Name (max. 17 ahar.) STATE SUPPLIED INFORMATION
<br />(check In fus\lf'\~5 "Sec.c n c ~-t 21. HSR. Corridor 10 (2.her,)
<br />one) D
<br />N"ar
<br />14, Highway Type & No. (max. 7 ahar.) 15. eNS Sign Installed (1-aOO) 111, Q~IO~ 22. Co~nly Map ReI. No. (max. 10 chlllr.)
<br />\Y)1j (") q Dyu ~o D partial
<br /> o 24hr D Unknown 23, Llltltuds (mex, 10 eMU., nn.nnnnnnn)
<br />17. e","nlng 'J"YPII 16. Croftslng PO$ltlon 19. er or fllauenQar SrrvlclI 20. AVlll1lfJ1l P~asllnOl!r TOil!n
<br />(chaox. on. only) . ~Grada AMTRAK Co~nt por Day 24. LongillldO (max, 11 char., nnn.nnnnnnn)
<br />[i;;YP~ blla Cl RR Under ~MTRAK & Other 2..
<br />o fIlrjvftta o RR OVllr Cl Olhllr 25. l.oULcmg souroll
<br />0.. PedllllMan o Nanfl o Alllulll Cl E;sllmlilllld
<br />20. Ie Ther!lan Adjll~o..lnll Wlth iii Sl!pllrllle Numbar1
<br />o Yal No II Yea, Provlda NumPllr (7 aharaaler~)
<br />27. PRIVATI'! CROaSING INFORMATION
<br />21.A. ClltOgory 21.6. Public Accesl 27.C. OnS/Slgnel.
<br />(oh.ck OM) o Raeraellonel D Yos None
<br />Cl Ferm Cllndustnlll o No o Signs Spl!clfy (mllx, III aher.)
<br />D Resldentl." o Commerolal D Unknown o Signals Spaclfy (max. 111 ahllr.)
<br />28.A, Railroad Use (mllx, 30 ahar.) 2a.A. Slala Use (me~. 20 aher.)
<br />28.B. Railroad Use (max. 20 ahar.) 29,B. Slala Use (mex. 20 ahar.)
<br />2e.C, . Railroad Uae (max. 20 ahar.) 29.C. Stale Usa (mll~. 20 ahar.)
<br />2e.e. Rallroilld Usa (mllx. 30ahar.) 29.0. State Use (max. 20 char,)
<br />JO. Nllrrllllve (mall. 100 ahar.)
<br /> ~..
<br />31. emargency Contlle! {Talephone No.) 1 J2. Rallroud Contllct (Telephone No,) I 33, Stllte Contae! (Telephone No.)
<br /> MUST COMPLETE REMAINDER OF FORM FOR PUBLIC VEHICLE CROSSINGS AT GRAOE
<br /> Psrt II: ~allroad 'nformalJQn
<br />1, N~mbar of Cally Trllln MovlImllnla
<br />1.A. Totlll Tllllns U. TollIl i$wllAhinll Traina r 1.C, Total Ollyllght T"r~ Trlllna (6 14fl B PM) 11.0. eMllck if loaa1'hlln Qnll MOVllmMt Per DIY
<br />28 0 CJ
<br />2, SpUd 01 Train at CllInlnll a,A. MIMlmum Tlmo Table Spollld (mph) 'lO 4 4Q
<br /> 2.a. Typical Spead RanQlI OVar Crolllng (mph) from 10
<br />3, TYPII und N~mbur ofTrllckl Main Olnor If Olher. Spoclfy (mllX. 10 char.) .
<br />4, Delea Anothllr FIR Oparata II SlIparDIII Traak al Croulng? 5. DouI Another RR Operllll Over Your Truck at OrQsllng?
<br />o Yea IfYos, Specify RR (max. 16 ahar.) ~Yas ....If Yas, Spaclly RR (maM. 16 char.)
<br />u;rNo , o No :t: c..t:: . t..\"l'... ,
<br />
<br />FORM FRA F 6180.71 (Rev. 11/99)
<br />
<br />OMB approval explre~ 8/31/2009
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<br />PAGS 1 OF Z
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<br />13
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