Bridge Maintenance Checklist Form
Inspection date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspected by
First Name
Last Name
Inspector Email
example@example.com
District
Name of the bridge
Latitude
Longitude
Have the following conditions been checked?
Rows
Yes
No
Repair damaged guard nail
1
2
Fill in Washout under Approach Slab
3
4
Rip-Rap Erosion on Side Slopes
5
6
Repair/Replace Signs
7
8
Sweep the Deck
9
10
Open Plugged Floor Drains
11
12
Clean Debris form Expansion Device
13
14
Repair Bridge Rail
15
16
Patch Bridge Deck
17
18
Remove Debris from Girders
19
20
Clean and Paint Ends of Girders
21
22
Remove Debris from Abutment Caps
23
24
Remove Debris from Pier Caps
25
26
Fill in Erosion at Abutments
27
28
Fill in Erosion at Piers
29
30
Remove Debris from Channel
31
32
Cut and Remove Trees from Channel
33
34
Fill in Roadway Settlement
35
36
Remove Silt from Barrels
37
38
Additional Notes
Inspector Signature
Submit
Should be Empty: