Curb Ramps |
Construction/Alteration Date (circle one): |
Before 1/26/92 |
After 1/26/92 |
|---|
| Facility Name/Address: | Date: |
| Location: | Surveyors: |
Record your measurements in the blanks when they are provided. Do not circle a response for a question you are
directed to skip. If your answer to a question is no, but the choices are “Y” and “n/a,” circle “n/a” (not applicable).
(A circled “N” signifies a violation). |
| Describe each curb ramp’s location: | Curb Ramp D: |
| Curb Ramp A: | Curb Ramp E: |
| Curb Ramp B: | Curb Ramp F: |
| Curb Ramp C: | Curb Ramp G: |
| Refer to # | Curb Ramp (CR) Questions |
Curb
Ramp A |
Curb Ramp B |
Curb Ramp C |
Curb Ramp D |
Curb Ramp E |
Curb Ramp F |
Curb Ramp G |
|||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 |
Is ramp of CR at least 36" wide (not including flared sides)? |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
" |
" |
" |
" |
" |
" |
" |
|||||||||
2 |
Does CR have a running slope of 8.33% or less? | Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
% |
% |
% |
% |
% |
% |
% |
|||||||||
3 |
Does CR have a cross slope of 2% or less? | Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
% |
% |
% |
% |
% |
% |
% |
|||||||||
4 |
Does CR have a gutter slope of 5% or less? | Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
% |
% |
% |
% |
% |
% |
% |
|||||||||
5 |
Are transitions on and off CR flush and
free of abrupt level changes? |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
" |
" |
" |
" |
" |
" |
" |
|||||||||
6 |
Does CR have detectable warnings? | Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
7 |
Can CR be blocked by legally parked cars? | Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
8 |
Is the sidewalk at the “top” of CR at least 36" wide? | Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
" |
" |
" |
" |
" |
" |
" |
|||||||||
9 |
Does CR have flared sides? If yes, answer one of the next two questions. If not, skip to question 10. |
Y |
n/a |
Y |
n/a |
Y |
n/a |
Y |
n/a |
Y |
n/a |
Y |
n/a |
Y |
n/a |
9.a |
If the sidewalk at the “top” of CR is 48" wide or more, is the slope of the flared sides 10% or less? | Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
% |
% |
% |
% |
% |
% |
% |
|||||||||
9.b |
If the sidewalk at the “top” of CR is less than 48" wide, is the slope of the flared sides 8.33% or less? | Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
% |
% |
% |
% |
% |
% |
% |
|||||||||
10 |
If no flared sides, is there an obstruction or
grass on each side of CR that discourages
pedestrians from traveling across ramp? If the CR has flared sides, skip this question. |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
11 |
If CR is built-up to the curb, is it
outside the path of cars? If CR is not built-up to curb, skip this question. |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Answer the last two questions only if the CR is located at a marked crossing: |
|||||||||||||||
12 |
Is ramp of CR contained in markings? | Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
13 |
If corner-type CR, is bottom landing at least
48" long and contained in crosswalk? If not corner-type CR, skip this question. |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
Y |
N |
" |
" |
" |
" |
" |
" |
" |
|||||||||
Comments: |
|
|---|---|
This survey form is designed to assist you in identifying common barriers to access – not all barriers. To identify all barriers, you must survey for compliance with §§ 4–10 of the ADA Standards |
|