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
Site Data Form

Ohio Department of Transportation
Abandoned Underground Mine Inventory and Risk Assessment

Site Data Form
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:________________
NOTE: Circle applicable items, and provide comments and sketch. Use back of forms or attach additional sheets as required.
  1. Site Investigations

    1. Evidence of Past Mining Activities

      1. Mine Openings

      2. Mine Structures (ruins/foundations of tipples, fanhouses, scalehouses, wash houses,etc.)

      3. Gob Piles

      4. Strip Pits

      5. Railroad Spurs

      6. Orange water/seeps/springs

      7. Contact Local Residents

    2. Surface Deformation Features

      1. Crack Patterns and Dips in Roadway

      2. Damaged or Displaced Drainage Structures

      3. Effects on Bridges, Structures, Poles, Culverts, etc.

      4. Unusual Vegetation

      5. Drag Patches

      6. Dips in Guard Rail

      7. Dips in Flowline of Ditches

      8. Low Spots Holding Water

      9. Ponds (unusual water formations on surface, impoundments)

      10. Surface Topography Anomalies

      11. Level of Groundwater

  2. Recording Information

    1. Record Mining and Geologic Information:

      • Mark Features with Ribbon, Paint,

      • Record Type and Apparent Minimum Overburden Thickness to Top of Mined Interval (if visible).
        • Estimate as one of the following:
          < 25'        25' - 50'       50' - 100'       > 100'

      • Record Maximum Mined Interval (seam(s)) Thickness, if outcrop is observable in site vicinity
        >6'        3' - 6'        0' - 3'
      • Record Number of Subsidences

      • Record Mine Opening Information:

        • Type(s) and Number(s) of Mine Opening(s). Types include: Drift (Horizontal), Slope, and Shaft (Vertical)
          Drift (Horizontal)_________Slope_________Shaft (Vertical) _________

        • Mine Opening Location(s) Relative to Roadway:

          Location Not Conclusively Known Between The Two Outer-Most Edge of Shoulders Less Than 50 Feet From Edge of Shoulder Between 50' and 100' From Edge of Shoulder Within Sight From Edge of Shoulder

        • Method of Mine Opening Closure, if Observable.

          No Information Timber Decking Random Backfill Concrete Cap Controlled Backfill

        • Type of Mine Opening Cribbing, if Observable

          No Information Timbers Brick Concrete

        • Plan Area of Mine Opening(s), if observable and safe to measure.

          Size Is Unknown >750 S. F From 500 to 750 S. F. From 250 to 500 S. F. From. 150 to 250 S. F. <150 S. F.
      • Record Field Observations of any other unique site features and describe the general site setting.

      • Check Information Recorded Against Information Reported on Field Data Sheet (if any).

      • Record Information Provided by Local Contacts (if any), including any information about secondary mining or problems reported during mining.

    2. Record Roadway Information:

      • Record Structures in Roadway site? (YES/NO)

        • Note type and condition of structure(s), including materials used in their construction.,

      • Record Posted Speed Limit Within Site Limits

      • Record Type of Pavement . In the case of asphalt surface, verify base pavement construction or reconstruction. Determine if rubblized. Indicate one of the following:

        Continuously Reinforced           Other
      • Record Evidence That The Mine Is Not Under The Roadway

    3. Sketch Features on Map / Roadway Plans/ Back of This Form

      • Determine Site Limits -Sketch on Map /Plans

      • Sketch in Topographic Anomalies

      • Sketch in All Recorded Features

        • Record elevations relative to the roadway
        • Measure and record dimensions of recorded features.

      • Record Bearing Between Features using a hand-held hiking compass

    4. Take Photographs:

      • Reference the Camera Position if Possible,

      • Use "Data Back" Film, or Record and Keep Notes with Film.

      • Photograph Multiple Angles of Significant Features

Updated: 06/27/2017
Federal Highway Administration | 1200 New Jersey Avenue, SE | Washington, DC 20590 | 202-366-4000