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|  FORM 7
DIAGNOSTIC TEAM
CROSSING EVALUATION REPORT
AAR/DOT NO.
Date of diagnostic Review:
LOCATION DATA
RAILROAD:
STATE:
COUNTY:
CITY (In or near)
R.R. DIVISION:
STREET/ROAD NAME:
NEAREST R.R. TIMETABLE STATION
R.R. MILEPOST
BRANCH/LINE NAME:
DIAGNOSTIC REVIEW
RAILROAD
STATE
LOCAL
OTHER
INITIATED BY
DATE INITIATED
NAME
AFFILIATION
1
2
3
4
5
6
7
RAILROAD DATA
Daily Train Movement
Check If Less Than
TYPE AND NUMBER OF TRACKS
One Movement Per Day
Total Trains
Amtrak Movement
MAIN .................
If Other Specific:
Per Day
OTHER ...............
Day Thru
SPEED OF TRAIN
Can two trains occupy crossing at the same time? Yes
No
Night Thru
Max ......................mph
Can one train block the motorist's
If yes, explain
view of another train at the
Day Switch
Typical ......... to ....... mph
crossing? If yes, explain. Yes
Night Switch
No
TRACK
TYPE
WIDTH
CONDITION
CROSSING ANGLE
ROADWAY DATA
AGENCY HAVING JURISDICTION
ADT
PERCENT TRUCK %
ROADWAY SURFACE
SPEED OF VEHICLE
SCHOOL BUS OPERATION
HAZARDOUS MTRLS.
PEDESTRIANS
MAX.......MPH
YES
NO
YES
NO
YES
NO
ROADWAY WIDTH
ROADWAY CONDITION
Typical ..... 10........mph
No Day
No Day
CURB & GUTTER
Yes
No
SHOULDER
Yes
If Yes, Width:
Is the shoulder surfaced
Yes
If yes, width:
Is sidewalk present?
Yes
No
No
No
SPECIAL CONDITIONS REQUIRED AS A RESULT OF NEARBY HIGHWAY INTERSECTIONS:
B-9
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