Product Design Worksheet – Structural Plate

9025 Centre Pointe Dr., Suite 400, West Chester, OH 45069 Email completed form to: info@conteches.com
800-338-1122 513-645-7000 513-645-7993 FAX

Project Information RUSH REQUEST:

Date: Respond By Date: Site Drawings Available: Specifications Available:
Project Name: Funding: End Market/Land Use:
Project City: State: Project Zip Code: Application:
Design Status: % Complete Permitted Approved Deliverable: Size/Cost Est. Proposal Drawing Quote

Structure Design Requirements

Structure Type: Structure Shape: Length: End Area :
Design Code: Live Load: Trench or Embankment Condition:
Invert Elevation: Min/Max. Span: Reline:
Roadway Elevation: Roadway Type: Min/Max. Rise: Grade Separation:
pH of water: Hydraulic Report Available: Max. HW Elevation:
Resistivity of water (Ω cm): Hydraulic Considerations: Flowline Elevation:

End Treatment
CIP Metal Modular Block Step Bevel Other
Length End Elevation Degree Inlet End Outlet End
Wingwall 1: Top Step: Top Step:
Wingwall 2: Slope (H:V): Slope (H:V):
Wingwall 3: Bottom Step: Bottom Step:
Wingwall 4:
Roadway Skew Angle: Skewed Ends Required:

H=
W=
C1=
C2=

Notes
(Design Assumptions, Challenges, Constraints, etc.)

Geotechnical Data
Soil Bearing Capacity (psf): _ psf Assumed Report Geotechnical Report Available:
Soilside Resistivity (Ω cm): Soilside pH: Foundation Type:
In-Situ: Young’s Modulus 1) Backfill Material: 1)
Poissons’ Ratio 2) 2)
Density 3) 3)

Contact Information
Name: E-mail:
Company: Phone:
Address: Fax:

©2012 Contech Engineered Solutions LLC CONTECH Project No.:______________ Region: ___________ www.ContechES.com