Manual for Abandoned Underground Mine Inventory and Risk Assessment
Initial Site Evaluation Form
| Ohio Department of Transportation Abandoned Underground Mine Inventory and Risk Assessment Initial Site Evaluation |
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| C/R/S/ (Mile Marker): ________________________________ Field Report / Office Investigation No._________________________ Site Description: ____________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ |
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| 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:_________________ |
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| ELIMINATED SITES SCREENING | ||||||||
| NOTE: Have site investigations and /or interviews conclusively proven that the identified mine(s) at this site is (are) not beneath the roadway ? | Yes_____ (SEE COMMENTS BELOW FOR BASIS OF THIS FINDING) No______ |
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| Criterion | Criterion Weighting Factor |
Site Condition / Rating Value | Individual Criterion Rating | |||||
|---|---|---|---|---|---|---|---|---|
| 1) | Evidence of Surface Deformation | Automatic Placement in Surface Deformation Group | yes |
no |
If "Yes", Proceed to Detailed Site Evaluation | |||
| 2) | Presence of Mine Opening(s) | Automatic Placement in Mine Opening Group For Detailed Site Evaluation | yes | no | If "Yes", Proceed to Detailed Site Evaluation | |||
| 3) | Ratio of Unconsolidated Materials to Bedrock in the Overburden Interval | 9 | Ratio = 1 or > 1 10 |
Ratio <1 1 |
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| 4) | Average Daily Volume of Traffic (ADT) | 9 | >30K 10 |
20K to 30K 8 |
10K to 20K 6 |
5K to 10K 4 |
< 5K 2 |
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| 5) | Hydrogeologic Setting | 8 | Dewatered 10 |
Flooded 8 |
Not Flooded 1 |
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| 6) | Minimum Overburden Thickness (Approx.) | 4 | < 25' 10 |
25' - 50' 8 |
50' - 100' 5 |
> 100' 1 |
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| 7) | Maximum Mined Interval Thickness (Approx.) | 4 | > 6' 10 |
3' -6' 5 |
0 - 3' 1 |
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| 8) | Ratio of Minimum Overburden Thickness To Maximum Mined Interval Thickness (Approx.) | 6 | Ratio < 5 10 |
Ratio= 5 to 11 5 |
Ratio >11 1 |
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| 9) | Secondary Mining | 4 | yes 10 |
no 1 |
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| Overall (Total) Site Evaluation Rating: | ||||||||
| COMMENTS (Attach additional sheets if necessary): 5/15/98 |
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