Form Revision: 27-Jun-07

BRIDGE LOAD RATING SUMMARY FORM

BRIDGE DATA Bridge Number: Struct. Type Main [Item 43] @: Struct. Type Appr. [Item 44] @: POSTING DATA Current Restrictions Item 41 @: Is Posting Needed: Proposed Restrictions Item 70 @: PROGRAM USED BASIS FOR ANALYSIS Design Drawings: As-Built Drawings: Shop Drawings: Field Measurements: Coupon Testing: Other: LIVE LOAD DISTRIBUTION AASHTO LFD: AASHTO LRFD: SALOD: BRUFEM: Finite Element on Grillage: LONGITUDINAL GOVERNING COMPONENT Main/Approach Span: Description: Material: Simple/Continuous Span: Span Length: Flexure, Shear or Principal Tension: TRANSVERSE GOVERNING COMPONENT Main/Approach Span: Description: Material: Deck, Box or Substructure: Flexure, Shear or Principal Tension: OTHER SPAN OF INTEREST (If Applicable)

OTHER SPAN OF INTEREST (If Applicable)

PONTIS DATABASE INPUT

PONTIS APPRAISAL TAB Description (NBIS Code) Design Load (31) @ Value PONTIS LOAD RATING 1 TAB Description (NBIS Code) Value
HS 20/HL 93 Governing Span Length

FT

PONTIS LOAD RATING 2 TAB Description (NBIS Code) FL 120 Longitudinal Governing Span Rating SEGMENTAL FL 120 Transverse Rating (Segmental)** Single Axle Transverse Rating** Tandem Axle Transverse Rating** Wing Span** Web-to-Web Span** MAXIMUM SPAN HS 20 Operating Rating Maximum Span** FL 120 Longitudinal Maximum Span #

Value Tons

Load Rating Origination

HL93, M9 (H10), M13.5 ((H15), M13.5 (HS15), M18 (H20), MS18 (HS20), MS18 (HS20)+Mod, Pedestrian, Railroad, MS22.5 (HS25), Unknown (NBI), Unknown (P), Not Applicable (P) Unknown, Design Plans, As-Built Plans, Field Measurements

Operating Type (63) @

Unknown, Load Factor, Allowable Stress, Load & Resistance Factor, Load Test, No Rating, Unknown (NBI), Not Applicable (P)

Load Rating Date Method Calculation

Unknown, AASHTO Formula, SALOD, BRUFEM, Other

Operating Rating (64)* @ ( ) Inventory Type (65) @

Tons

Load Distribution Factor Impact Factor Design Method

Unknown, Working Stress, Load Factor, LRFD, Others

Tons Tons Tons FT FT

Unknown, Load Factor, Allowable Stress, Load & Resistance Factor, Load Test, No Rating, Unknown (NBI), Not Applicable (P)

Design Measure
Unknown, English, Systeme International

Inventory Rating (66)* @ ( )

Tons

Tons Tons

LEGEND * If rating is provided as a factor from an LRFR analysis, multiply the rating factor by 36 tons ** If not calculated, enter "-1" # LRFR Rating Only ## If Posting is not required, enter "99" @ BMS Coding Manual available on the FDOT Office of Maintenance website ( ) List Controlling Member & (M=moment, V=shear, pt=post-tensioning) for this Rating COMMENTS BY ENGINEER

TRUCK OPERATING RATINGS SU 2** Enter Contr. Mem. ( ) SU 3** Enter Contr. Mem. ( ) SU 4** Enter Contr. Mem. ( ) C 3** Enter Contr. Mem. ( ) C 4** Enter Contr. Mem. ( ) C 5** Enter Contr. Mem. ( ) ST 5** Enter Contr. Mem. ( ) Recommended SU Posting ## Recommended C Posting ## Recommended ST Posting ##

Tons Tons Tons Tons Tons Tons Tons Tons Tons Tons

FLOOR BEAM Floor Beam Present Governing Floor Beam Span** Governing Floor Beam Spacing** Floor Beam HS 20 Rating** Floor Beam SU 4 Rating** Floor Beam Inventory Rating Factor** # Floor Beam Operating Rating Factor **# Floor Beam FL 120 Rating # No = Stop Yes = Continue FT FT Tons Tons

Tons

Responsible Engineer: FL P.E. #: Date: Address:

COMPUTATIONS Performed By: Checked By: Reviewed By: Date: Date: Date:

Seal

Form Revision: 27-Jun-07 Item 43 & 44 Coding is a three digit number with the first digit being the material and the second and third being the design (Example: a concrete multi-beam superstructure would be coded as a "102") Type of Material Type of Design/Construction 1- Concrete 01- Slab 12- Arch - Thru 2- Concrete continuous 02- Multi-beam or Multi-girder 13- Suspension 3- Steel 03- Girder-Floorbeam (GF) or Girder-Floorbeam-Stringer 14- Cable Stayed Girder 4- Steel continuous 04- Tee Beam or Double Tee Beam 15- Movable - Lift 5- Prestressed conrete* 05- Box Beam or Girders - Multiple* 16- Movable - Bascule 6- Prestressed concrete continuous* 06- Box Beam or Girders - Single or spread* 17- Movable - Swing 7- Wood or Timber 07- Frame (except frame culverts) 18- Tunnel 8- Masonry 08- Orthotropic 19- Culvert (includes frame culverts) 9- Aluminum, Wrought Iron or Cast Iron 09- Truss - Deck 21- Segmental Box Girder 0- Other 10- Truss - Thru or Pony 22- Channel Beam 11- Arch - Deck 00- Other * Multiple = Box Beams or Girders in contact. * Post-tensioned concrete should be coded as prestressed concrete. Spread = Box Beams or Girders are spaced apart from each other.

Item31 Design Loads HL93 M9 (H10) M13.5 (H15) M13.5 (HS15) M18 (H20) MS18 (HS20) MS18 (HS20)+Mod Pedestrian Railroad MS22.5 (HS25) Unknown (NBI) Unknown (P) Not Applicable (P)

YesNo Yes No

Span Main Approach

Design Simple Continuous

TransGovMem Deck Box Substructure

TransGovLoad Flexure Shear Principal Tension

Material Concrete Steel Prestressed Conc Timber Masonry Other DgnMeas Unknown English Systeme International MomShr (M) (V) (pt) ( )

Item6365 Oper/Inv Type Unknown Load Factor Allowable Stress Load & Resistance Factor Load Test No Rating Unknown (NBI) Not Applicable (P)

LoadOrig Unknown Design Plans As-Built Plans Field Measurements

MethCalc Unknown AASHTO Formula SALOD BRUFEM Other

DgnMeth Unknown Working Stress Load Factor LRFD Others

Description Slab Multi-Beam Girder-Floorbeam Tee Beam Box Beam Orthotropic Truss Arch Suspension Cable Stayed Movable Tunnel Culvert Segmental Channel Beam Other

Short Description Open, No Restrictions Posting Recommended Open, Str. Anal. not Comp. Open, Temp Shored Open, Temp Structure Proposed Bridge New - Not yet Open Closed to all Traffic Posted for Load Posted for non-Load Deleted Bridge

Codes A B C D E F G K P R Z

Item41 Description OPEN, NO RESTRICTIONS - open, no restriction required. POSTING RECOMMENDED - open, posting recommended but not legally implemented (all signs not in place). OPEN, STR ANAL NOT COMP - open, structural analysis is not yet completed. OPEN, TEMP SHORED - open, would be posted or closed except for tremporary shoring, etc., to allow for unrestricted traffic. OPEN, TEMP STRUCT - open, temporary structure in place to carry legal loads while original structure is closed and awaiting replacement or rehabilitation. PROPOSED BRIDGE -bridge is proposed or under construction. NEW - NOT YET OPEN - new structure not yet open to traffic. CLOSED TO ALL TRAFFIC - bridge closed to all traffic. POSTED FOR LOAD - posted for load (may include other restrictions). POSTED FOR NON-LOAD - posted for other restriction (speed, number of vehicles on bridge, load restriction when none is required, etc.). DELETED BRIDGE - structure deleted from active list (assign to central office district).

Item70 Relationship of Operating Rating Stress to Legal Code Load Stress (Operating Factor) 5 At/Above Legal Loads 1.000 up 4 0.1 to 9.9% BELOW 0.901 - 0.999 3 10.0 to 19.9% BELOW 0.801 - 0.900 2 20.0 to 29.9% BELOW 0.701 - 0.800 1 30.0 to 39.9% BELOW 0.601 - 0.700 0 > 39.9% BELOW 0.000 - 0.600

Posting Not Required Required Required Required Required Required

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