Dot Form 234-030 - Prestressed Concrete Damage Drawing Template - Washington State Department Of Transportation

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Bridge Number:________________
Inspected By:__________________
Bridge Name:__________________
Notes:________________________________________________
_____________________________________________________
Date: ________________________
Prestressed Concrete Damage
Bridge Number:________________
Inspected By:__________________
_____________________________________________________
Looking:______________________
Drawing Template
_____________________________________________________
Bridge Name:__________________
Notes:________________________________________________
Location:______________________
____________________________________________
_____________________________________________________
Date: ________________________
Bridge Number:________________
Inspected By:__________________
_____________________________________________________
Bridge Number:
Inspected By:
Looking:______________________
_____________________________________________________
Bridge Name:__________________
Notes:________________________________________________
Bridge Name:
Notes:
Location:______________________
____________________________________________
_____________________________________________________
Bulb
Date: ________________________
Date:
_____________________________________________________
Looking:______________________
_____________________________________________________
Looking:
Location:______________________
____________________________________________
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Location:
Bulb
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DOT Form 234-030
Revised 10/2015

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