U.S. Department of Transportation
Federal Highway Administration
1200 New Jersey Avenue, SE
Washington, DC 20590
202-366-4000


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Manual for Abandoned Underground Mine Inventory and Risk Assessment
Detailed High Rating Site Evaluation Form


Ohio Department of Transportation
Abandoned Underground Mine Inventory and Risk Assessment

Detailed High Rating Site Evaluation
C/R/S/ (Mile Marker): _______________________________ Field Report / Office Investigation No.__________________________
Site Description: ____________________________________________________________________________________________
__________________________________________________________________________________________________________
U.S.G.S. Topographic
Quadrangle ODOT No.:______________
O.D.N.R. Abandoned Underground
Mine Series (U.S.G.S.) Map:______________
O.D.N.R.,DGS Individual Abandoned
Underground Mine Map Index No.:______________
(If known.)

Name of Site Evaluator:________________________________________________Evaluation Date:________________
  Criterion Criterion
Weighting
Factor
Site Condition / Rating Value Individual Criterion Rating
1)   Minimum Overburden Thickness (Approx.) 4 < 25'
10
25' - 50'
8
50' - 100'
5
>100'
1
   
2)   Recent Dewatering 10 <1 Yr.
10
1 to 3 Yrs.
9
4 to 6 Yrs.
4
7 to 9 Yrs.
2
>9 Yrs.,
Unknown,
Dry Mine

1
 
3)   Average Daily Traffic (ADT) 9 >30K
10
20K to 30K
8
10K to 20K
6
5K to 10K
4
< 5K
2
 
4)   Classification of Roadway
( NOTE: For intersecting Roads, See Implementation Manual)
9 I.R.
10
NHS Other Than IR
7
Arterial
5
Collector
1
   
5)   Extraction 8 Secondary
10
>50%
7
Unknown
5
<50%
1
   
6)   Maximum Mined Interval Thickness (Approx.) 8 >6'
10
3' - 6'
5
0' - 3'
1
     
7)   Age of Mining 8 <1900, or Unknown
10
1900-1930
9
1931-1945
7
1946-1968
5
> 1968
1
 
8)   Ratio of Unconsolidated Materials to Bedrock in the Overburden Interval 8 Ratio= 1 or > 1
10
Ratio <1
1
       
9)   Ratio of Minimum Overburden Thickness To Maximum Mined Interval Thickness(Approx.) 6 Ratio < 5
10
Ratio = 5 to 11
5
Ratio >11
1
     
10)   Average Daily Truck Traffic (ADTT) 5 >6K
10
4K to 6K
8
2K to 4K
6
1K to 2K
4
< 1K
2
 
11)   Type of Pavement 5 Other
10
Continuously Reinforced
1
       
12)   Structures in Roadway 3 Yes
10
No
0
       
13)   Traffic Speed 3 >35 MPH
10
0 to 35 MPH
1
       
14)   Availability of Reasonable Detour Routes 3 None
10
Yes
0
       
15)   Special Mine Features 2 Intersecting Haulways
10
Entry
5
Large Room
5
None
0
   
16)   Problems Reported During Active Mining 2 Yes
10
No/Not Known
0
       
Overall (Total) Site Evaluation Rating:    
COMMENTS (Attach additional sheets if necessary):
5/15/98
Updated: 06/27/2017
Federal Highway Administration | 1200 New Jersey Avenue, SE | Washington, DC 20590 | 202-366-4000