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<br />1<(, <br /> <br />DEPARTMENT OF HIGHWAYS <br />STATE OF COLORADO <br />DIVISION OF HIGHWAYS <br />DOH Form No. 293 <br />Rev. June, 1983 <br /> <br />SEND TO: <br /> <br />STAFF DESIGN <br />HYDRAULICS UNIT <br />4201 East Arkansas Avenue <br />Denver, CO 80222 <br /> <br />DRAINAGE STRUCTURE FLOOD SUMMARY <br /> <br />CAUSE: <br />Rainfall g <br /> <br />DATE OF FLOODING <br /> <br />Snowmelt 0 <br /> <br />Other <br /> <br /> <br /> <br />FLOODING LOCATION (Include SH No., direction and distance from a reference point such as a highway junction, major <br />structure, geographical reference, or milepost.) <br /> <br />STREAM NAME <br /> <br /> <br /> <br />Type <br /> <br />. <br />STRUCTURE NO. <br /> <br /> <br /> <br />(Give local reports of the depth and duration of the rainfall. Indicate ground moisture condition <br /> <br />DEPTH OF WATER OVER ROA <br />11 <br /> <br />DEBRIS: (Indicate the d <br /> <br />Trees I/ilI Brush ~ <br /> <br />Rocks 0 <br /> <br />Silt PJI <br /> <br />Other <br /> <br />Amount s.: W A <br /> <br />WATER DEPTH AT STRUCTURE ENTRANCE: (Referencethehighwatertosome permanent object such asthebo llomofa <br />bridge girder, top of the culvert, or shoulder of the roadway. This should be as accurate as possible.) <br /> <br /> <br /> <br />( <br /> <br /> <br />DAMAGE OR SCOUR: Yes No 0 <br />If yes, specify (Describe extent of damage and needed repair.) <br /> <br />Chlo~n .rJ.I'l!' /,~II':' d",H-'jl'/ A~~C'~Alr ~ ",,/..III'ftO~. <br /> <br />COMMENTS: (List any pertinent facts, such as traffic delays, detours, duration of highwater. Suggestions for improving design <br />to alleviate problem. AlSO) list any other undocumented flood history at this location) .. <br />$)j",,4/' W,#f c./8m/ FI,., . Jet. .;'1 tl-JrS ~ $.,..'~;f,.l .J:-,., /~-Id n .!UI. <br />;:7.a'/'? ~r 6~1 M ?"-,,t- .. . . . <br /> <br />,#dt!,'h;;oIA/ t!"j~,,* ~~:;.;. 4 ';',i~/J/ Il.o'l. ~ ,.",alwA,,)f .Hd...;;/. ~ J;.,-.jf'. <br />JJ,;{.r......."...J . ~.. ..7/~,-" I .. . .N )", <br />e...... ( !:,'~ v ' . .> E" cI 14 'Y; ':: t.1 k f:: 7. {J170 A v ~, c..( '" <br />SOURCE OF INFORMATION: (Give name of person(s) observing the highwateror damage. <br />List address and phone number so he may be contacted for additional information. <br />I~cly~, years ,f'}"'iliy with area) /, v) <br />/iIH;e/ ,M-...nc ~Y'l1 t.RJ. J J;/,,/:, ,JUo. :!OJ'.l~~ '7~(. ~ J:.u,,..,/ '''''''1: <br />EJ,,,, b~/ P9>6 t.. ;fJ..z. kj~6N) CU. jIJ.J-JS'/--mf (L;/~;1;'t') <br /> <br />7Zt J',,"'~f IllY- !1,t/..Jt Xr.> f.~. ;70J~75f-'.;7! (I/!J-d'). <br /> <br />~ l.-.~ ... .- <br /> ,. <br />I/) ~ <br />;z: i;' <br />Z "'ll <br />~ 0 <br />... <br /> - <br /> <br />,; " <br /> <br /> <br /> <br /> <br />(Date) <br /> <br />Phone <br /> <br /> <br />Use ro.e... oIde lor any additional commenl., .kelche., or photograph.. <br /> <br />