Form CEM-2312 "Temporary Pedestrian Access Route Contractor Weekly Report" - California

What Is Form CEM-2312?

This is a legal form that was released by the California Department of Transportation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2017;
  • The latest edition provided by the California Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CEM-2312 by clicking the link below or browse more documents and templates provided by the California Department of Transportation.

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Download Form CEM-2312 "Temporary Pedestrian Access Route Contractor Weekly Report" - California

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STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
TEMPORARY PEDESTRIAN ACCESS ROUTE CONTRACTOR WEEKLY REPORT
Page 1 of 5
CEM-2312 (NEW 11/2017)
PROJECT INFORMATION/NAME
CONTRACT NUMBER/CO/RTE/PM
PROJECT IDENTIFICATION NUMBER
CONTRACTOR NAME
LOCATION NUMBER
CITY
COUNTY
ROUTE NAME
INSPECTION DATE
Temporary Pedestrian
Cross Street
Postmile or Station
Latitude (y)
Longitude (x)
Access Route Begin
Temporary Pedestrian
Cross Street
Postmile or Station
Latitude (y)
Longitude (x)
Access Route End
Sidewalk Closure Duration
Temporary Pedestrian Access
Estimate End Use of Temporary
Sidewalk Closure Duration
Route Opened for Use
Pedestrian Access
Short Term
Standard Plans
Long Term
Contract Plans
Date:
Date:
Contractor Provided
(see page 5)
SIDEWALK DETOUR INSPECTION CHECKLIST
Begin Temporary Pedestrian Access Route
No.
Requirement
Compliant
Photo
Remarks
Action Number
1
Sidewalk closed ahead signs in place?
Yes
No
Yes
Yes
2
Sidewalk closed sign mounted on barrier at closure?
Yes
No
Yes
Yes
3
Barrier provided full width of the closed sidewalk?
Yes
No
Yes
Yes
If audible information devices are used, is the device operational
4
Yes
No
N/A
Yes
Yes
and message provides appropriate information?
End Temporary Pedestrian Access Route
No.
Requirement
Compliant
Photo
Remarks
Action Number
1
Sidewalk closed ahead signs in place?
Yes
No
Yes
Yes
2
Sidewalk closed sign mounted on barrier at closure?
Yes
No
Yes
Yes
3
Barrier provided full width of the closed sidewalk?
Yes
No
Yes
Yes
If audible information devices are used, is the device operational
4
Yes
No
N/A
Yes
Yes
and message provides appropriate information?
Remarks
The following must be completed for non-compliant items:
Action
Comment
Corrective Action Required
Date Corrective Action
Number
Completed
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
TEMPORARY PEDESTRIAN ACCESS ROUTE CONTRACTOR WEEKLY REPORT
Page 1 of 5
CEM-2312 (NEW 11/2017)
PROJECT INFORMATION/NAME
CONTRACT NUMBER/CO/RTE/PM
PROJECT IDENTIFICATION NUMBER
CONTRACTOR NAME
LOCATION NUMBER
CITY
COUNTY
ROUTE NAME
INSPECTION DATE
Temporary Pedestrian
Cross Street
Postmile or Station
Latitude (y)
Longitude (x)
Access Route Begin
Temporary Pedestrian
Cross Street
Postmile or Station
Latitude (y)
Longitude (x)
Access Route End
Sidewalk Closure Duration
Temporary Pedestrian Access
Estimate End Use of Temporary
Sidewalk Closure Duration
Route Opened for Use
Pedestrian Access
Short Term
Standard Plans
Long Term
Contract Plans
Date:
Date:
Contractor Provided
(see page 5)
SIDEWALK DETOUR INSPECTION CHECKLIST
Begin Temporary Pedestrian Access Route
No.
Requirement
Compliant
Photo
Remarks
Action Number
1
Sidewalk closed ahead signs in place?
Yes
No
Yes
Yes
2
Sidewalk closed sign mounted on barrier at closure?
Yes
No
Yes
Yes
3
Barrier provided full width of the closed sidewalk?
Yes
No
Yes
Yes
If audible information devices are used, is the device operational
4
Yes
No
N/A
Yes
Yes
and message provides appropriate information?
End Temporary Pedestrian Access Route
No.
Requirement
Compliant
Photo
Remarks
Action Number
1
Sidewalk closed ahead signs in place?
Yes
No
Yes
Yes
2
Sidewalk closed sign mounted on barrier at closure?
Yes
No
Yes
Yes
3
Barrier provided full width of the closed sidewalk?
Yes
No
Yes
Yes
If audible information devices are used, is the device operational
4
Yes
No
N/A
Yes
Yes
and message provides appropriate information?
Remarks
The following must be completed for non-compliant items:
Action
Comment
Corrective Action Required
Date Corrective Action
Number
Completed
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
TEMPORARY PEDESTRIAN ACCESS ROUTE CONTRACTOR WEEKLY REPORT
Page 2 of 5
CEM-2312 (NEW 11/2017)
PROJECT INFORMATION/NAME
CONTRACT NUMBER/CO/RTE/PM
PROJECT IDENTIFICATION NUMBER
CONTRACTOR NAME
LOCATION NUMBER
CITY
COUNTY
ROUTE NAME
INSPECTION DATE
GENERAL INSPECTION CHECKLIST
No.
Requirement
Compliant
Photo
Remarks
Action Number
1
Pedestrian walkway is firm and stable?
Yes
No
Yes
Yes
Surface is smooth with no abrupt changes in grade that could
2
Yes
No
Yes
Yes
cause tripping or be a barrier to wheelchairs?
3
Surface discontinuities do not exceed ½-inch maximum?
Yes
No
Yes
Yes
4
Surface is clear of dirt and debris?
Yes
No
Yes
Yes
5
Pedestrian walkway has no horizontal obstructions restricting width?
Yes
No
Yes
Yes
6
Vertical clearance is minimum 80 inches?
Yes
No
Yes
Yes
Signs or other devices mounted lower than 7 feet do not protrude
7
Yes
No
Yes
Yes
into the pedestrian pathway more than 4 inches?
8
Access to temporary transit stops is provided?
Yes
No
N/A
Yes
Yes
TEMPORARY RAMPS
(if yes, complete items 9-11)
Yes
No
9
Pedestrian ramp is firm and stable?
Yes
No
Yes
Yes
Surface is smooth and no abrupt changes in grade that could
10
Yes
No
Yes
Yes
cause tripping or be a barrier to wheelchairs?
11 Hand railings are provided on both sides of ramp walkway?
Yes
No
Yes
Yes
TEMPORARY CURB RAMPS
(if yes, complete items 12-14)
Yes
No
12 Pedestrian curb ramp is firm and stable?
Yes
No
Yes
Yes
Surface is smooth and no abrupt changes in grade that could
13
Yes
No
Yes
Yes
cause tripping or be a barrier to wheelchairs?
14 Detectable warning surface in place?
Yes
No
Yes
Yes
Remarks
The following must be completed for non-compliant items:
Action
Comment
Corrective Action Required
Date Corrective Action
Number
Completed
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
TEMPORARY PEDESTRIAN ACCESS ROUTE CONTRACTOR WEEKLY REPORT
Page 3 of 5
CEM-2312 (NEW 11/2017)
PROJECT INFORMATION/NAME
CONTRACT NUMBER/CO/RTE/PM
PROJECT IDENTIFICATION NUMBER
CONTRACTOR NAME
LOCATION NUMBER
CITY
COUNTY
ROUTE NAME
INSPECTION DATE
GENERAL INSPECTION CHECKLIST
No.
Requirement
Compliant
Photo
Remarks
Action Number
TEMPORARY CURB RAMPS
(if yes, complete items 15-17)
Yes
No
15 For traffic signals, is the pedestrian push button working?
Yes
No
Yes
Yes
16 Is the pedestrian push button wheelchair accessible?
Yes
No
Yes
Yes
17 For push button with locator tone, is the tone audible?
Yes
No
Yes
Yes
FALSEWORK
(if yes, complete items 18-23)
Yes
No
18 Protective overhead cover provided entire length?
Yes
No
Yes
Yes
19 Vertical clearance is 80 inches minimum?
Yes
No
Yes
Yes
Signs or other devices mounted lower than 7 feet do not protrude
20
Yes
No
Yes
Yes
into the pedestrian pathway more than 4 inches?
21 Hand railings provided on both sides of walkway?
Yes
No
Yes
Yes
Bottom rail provided is maximum 2 inches above walkway surface
22
Yes
No
Yes
Yes
on both sides of the walkway?
23 Falsework lighting is in working order?
Yes
No
Yes
Yes
Remarks
The following must be completed for non-compliant items:
Action
Comment
Corrective Action Required
Date Corrective Action
Number
Completed
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
TEMPORARY PEDESTRIAN ACCESS ROUTE CONTRACTOR WEEKLY REPORT
Page 4 of 5
CEM-2312 (NEW 11/2017)
PROJECT INFORMATION/NAME
CONTRACT NUMBER/CO/RTE/PM
PROJECT IDENTIFICATION NUMBER
CONTRACTOR NAME
LOCATION NUMBER
CITY
COUNTY
ROUTE NAME
INSPECTION DATE
CONTRACTOR INSPECTION INFORMATION
The following must be completed by the contractor for quality control inspections
Yes
No
Project Manager Notified of Corrective Actions
The temporary pedestrian access route has been inspected and is in
Date:
compliance with the plans and specifications?
Quality Control Inspector (Print Name)
Signature
Date
Yes
No
All Corrective Actions Completed
The temporary pedestrian access route has been re-inspected and all
Date:
non-compliance issues have been corrected?
N/A
Quality Control Inspector (Print Name)
Signature
Date
I have reviewed the quality control inspection report for compliance with the contract plans and specifications and corrective action has been
taken when required.
Contractor Project Manager (Print Name)
Signature
Date
Submitted By (Print Name)
Date
Submit the completed form in Adobe *.pdf format to the
resident engineer within 2 business days after inspection.
RESIDENT ENGINEER
I have reviewed the temporary pedestrian access route contractor weekly report and temporary pedestrian access route is compliant.
Resident Engineer (Print Name)
Signature
Date
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
TEMPORARY PEDESTRIAN ACCESS ROUTE CONTRACTOR WEEKLY REPORT
Page 5 of 5
CEM-2312 (NEW 11/2017)
GENERAL INFORMATION
The Americans with Disabilities Act (ADA) of 1990, along with its implementing regulations, and the California Government Code
Sections 4450 et seq. prescribe that facilities shall be made accessible to persons with disabilities.
The Federal Highway Administration (FHWA) has recommended that the Americans with Disabilities Act Accessibility Guidelines for
Buildings and Facilities (ADAAG) shall apply to the design of the California Department of Transportation (Caltrans) facilities.
This form is to provide documentation that temporary pedestrian access routes are compliance with ADA Standards to meet ADA
requirements.
Title 24 of the California Code of Regulations (Title 24) is similar to the ADAAG in that it prescribes accessibility design standards for
the State of California, in Part 2, the California Building Code. The Department of General Services - Division of the State Architect
(DSA) oversees California Building Code compliance; however, for transportation facilities on the state highway system, Caltrans, in
addition to DSA, is authorized to certify, on a project-by-project basis, that a project complies with state pedestrian accessibility design
standards.
Design Information Bulletin 82, “Pedestrian Accessibility Guidelines for Highway Projects” (DIB 82), is Caltrans policy for design
requirements to verify that Caltrans projects comply with state and federal laws, regulations, and codes regarding pedestrian
accessibility.
Contact the district ADA coordinator for additional information about ADA requirements.
FORM
Complete the form for each temporary pedestrian access route and ensure non-compliant accessibility features are corrected before
allowing use of the temporary pedestrian access route by pedestrians.
CONTRACT NUMBER/CO/RTE/PM: For local agency encroachment permit projects, write the encroachment permit number in the
CONTRACT NUMBER field.
PROJECT IDENTIFICATION NUMBER: For local agency encroachment permit projects, write N/A in the field.
Establish a location number for each temporary pedestrian access route location.
For each temporary pedestrian access route location provide:
County
City
Route
Route name (e.g. State Route 49)
Name of the cross street
Latitude and longitude must be in decimal format to a minimum of six decimal places. Free GPS applications for smart phones, tablets,
and desk tops will report latitudes and longitudes to the necessary accuracy for differentiation of the temporary pedestrian locations.
Sidewalk closure duration:
Short term 5 business days or less
Long term greater than 5 business days
ADA COMPLIANCE
The contractor’s project manager must:
Review the completed form and determine if the temporary pedestrian access route is compliant.
Notify the contractor’s quality control inspector of any necessary corrective actions and ensure corrective actions are addressed as
soon as possible.
Provide a copy of the completed inspection report to the resident engineer.
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