HomeMy WebLinkAbout20181426.tiffRESOLUTION
RE: APPROVE APPLICATION TO REMOVE EXISTING PASSING WARNING SIGNS,
CROSSING SURFACE AND ROAD APPROACHES TO CLOSE THE EXISTING
CROSSING AT TRACKS OWNED BY UNION PACIFIC RAILROAD COMPANY
CROSSING COUNTY ROAD 104, AND AUTHORIZE SUBMITTAL
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with an Application to the Public Utilities
Commission(PUC), related to the removal of certain safety improvements and closure of the
Union Pacific Rail Road Company Crossing at County Road 104, and
WHEREAS, after review, the Board deems it advisable to approve said application, a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Application to the Public Utilities Commission (PUC), be and hereby
is, approved.
BE IT FURTHER RESOLVED by the Board that the Colorado Department of
Transportation, be, and hereby is, authorized to submit said application.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 2nd day of May, A.D., 2018.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: diriwt)
Weld County Clerk to the
Deputy CI rk to he
ounty Attorney
Date of signature: os
Sean P. Conway
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Mike Freeman
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2018-1426
EG0075
Cheryl Hoffman
From:
Sea.n a
To:
Cc:
Subject:
Attachments:
Good morning,
Elizabeth Relford
Monday, April 30, 2018 9:19 AM
CTB
Bruce Barker; Barbara Kirkmeyer; Jay McDonald; Don Dunker
FW: Weld Co Rd 46-UPRR, UP contact, PUC app + exhibits
804354S CR 46 Greeley Sub UP Master Task Order Form CDOT Section 130
121817.docx; Exhibit A-CR 46 FRA Inventory Report.pdf; Exhibit B-CR 46 Accident
Report.pdf; Exhibit D -Weld CR 46 Vicinity Map.docx; Exhibit E -804352D CR 44 Crossing
Inventory.pdf; Exhibit F -804352D CR 44 Accident Report.pdf; Exhibit G -804355Y CR 48
Crossing Inventory.pdf; Exhibit H -804355Y CR 48 Accident Report.pdf; Exhibit J -Notice
of Proposed Closing of This Crossing-CR 46.docx; PUC Application Template-CR 46
Weld Co -DRAFT 010318_SAnzia.docx
I have multiple emails to send to you in order to get the following PUC applications on Wednesday's BOCC agenda.
Here is a list of the Group one PUC applications:
1. WCR 2.5
2. WCR 29
3. WCR 46
4. WCR 72
5. WCR 104
CDOT will be submitting the applications, so we do not need the Chair's signature on anything, but the purpose of the
agenda items is to have the Board agree to give authorization to CDOT to submit the PUC applications on behalf of the
county. I wasn't sure if you wanted to combine the action into one agenda item or do them separately? I also assumed
the Board would want to see the PUC applications, which essentially is what I am forwarding to you. This group one
package is not the official closure of these roads. I assume the Board would consider that action after these went
through the PUC process.
The attachments on this email are for just WCR 46. I have similar attachments for each closure, so please let me know
how you would like to proceed.
Thanks,
Elizabeth
Elizabeth Relford
Deputy Director
Weld County Public Works
1111 H Street
PO Box 758
Greeley, CO 80632-0758
Email: erelford@co.weld.co.us
Office: (970) 400- 3748
Mobile: (970) 673-5836
Web: h ttp://www.co.weld.co.us
2018-1426
1
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contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
From: Martindale - CDOT, Rob[mailto:rob.martindale@state.co.us]
Sent: Sunday, April 29, 2018 7:28 PM
To: Elizabeth Relford <erelford@weldgov.com>
Subject: Fwd: Weld Co Rd 46-UPRR, UP contact, PUC app + exhibits
Elizabeth,
Please find the application and supporting documents attached.
Thanks,
Rob Martindale
Railroad/Utility Program Manager
C.R..
e.L, pagent of Transportation
Dwoork P. .
Mobile: 970021005913 I Office: 970.683.6357 I F 970Q683,6227
4201 E Arkansas Ave Denver, CO 80222
robomartindate®stateocoous wwwmcoloradodotoinfo I wwwecotripaorg
2
BEFORE THE PUBLIC UTILITIES COMMISSION OF THE STATE OF COLORADO
PROCEEDING NO.
IN THE MATTER OF THE APPLICATION OF THE COLORADO DEPARTMENT OF
TRANSPORTATION, ON BEHALF OF WELD COUNTY, FOR AUTHORITY TO REMOVE
EXISTING PASSING WARNING SIGNS, CROSSING SURFACE AND ROAD
APPROACHES TO CLOSE THE EXISTING CROSSING AT TRACKS OWNED BY UNION
PACIFIC RAILROAD COMPANY CROSSING COUNTY ROAD 104, USDOT NO. 804-865C,
IN WELD COUNTY, STATE OF COLORADO.
APPLICATION
The Colorado Department of Transportation, hereinafter referred to as "CDOT", on
behalf of the County of Weld, hereby submits this application to the Colorado Public Utilities
Commission, hereinafter referred to as "PUC", for an order authorizing the removal of existing
passive warning signs and crossing surface, and removal of roadway approaches to close the
existing County Road 104 crossing of Union Pacific Railroad, hereinafter referred to as "UPRR"
or "Railroad" tracks for which CDOT has appropriated Federal Section 130 Funds in Weld
County, State of Colorado.
Following are CDOTs responses to the specific requirements concerning highway -rail
grade crossing applications, as prescribed in 4 Code of Colorado Regulations (CCR) 723-7-
7002(b)(I-IX), 4 CCR 723-7204(a)(I), and 4 CCR 723-7-7204(a)(II) - (XVIII) and 4 CCR 723-
7-7205 as required, including without limitation, acknowledgement that by signing the
application, CDOT understands that the filing of the application does not by itself constitute
approval of the application for the requested action.
Consistent with Rule 7002(b), 4 CCR 723-7, the information below is provided within
this application, or in an appropriately identified attachment to this application as indicated.
Information Required ll Rule 7002(b)
A. Rule 7002(b)(I)
The name and mailing address of CDOT:
Colorado Department of Transportation
4201 East Arkansas Avenue
Denver, CO 80222
1
B. Rule 7002(b)(II)
If the applicant is a corporation or limited liability company; the name of the state in
which the applicant is incorporated or organized and the location of its principal office, if
any, in Colorado:
CDOT is not a corporation or a limited liability company.
C. Rule 7002(b)(III)
If the applicant is a partnership; the names, titles and addresses of all general and limited
partners:
CDOT is not a partnership.
D. Rule 7002(b)(IV)
The name, address, telephone number, and e-mail address of the applicant's
representative to whom all inquiries concerning the application may be made:
Rob Martindale
Railroad Program Manager
Colorado Department of Transportation
4201 East Arkansas Avenue, 4th Floor
Denver, CO 80222
Ph: 970-210-5913
Email: rob.martindale@state.co.us
E. Rule 7002(b)(V)
A statement that the applicant agrees to respond to all questions propounded by the
Commission or its staff concerning the application:
CDOT agrees to respond to all questions propounded by the Commission or its staff
concerning the application.
F. Rule 7002(b)(VI)
A statement indicating the town or city, and any alternative town or city, where the
applicant prefers any hearings to be held:
CDOT prefers any hearings to be held at the Commission office in Denver, or, in the
alternative, at any other location which the Commission may designate.
G. Rule 7002(b)(VII)
A statement that the applicant understands that, if any portion of the application is found
to be false or to contain material misrepresentations, any authorities granted pursuant to
the application may be revoked upon Commission decision:
2
CDOT understands that, if any portion of the application is found to be false or to
contain material misrepresentations, any authorities granted pursuant to the
application may be revoked upon Commission decision.
H. Rule 7002(b)(VIII)
Acknowledgement that by signing the application, the applicant understands that:
1. The filing of the application does not by itself constitute approval of the application
for the requested action;
2. If the application is granted, the applicant shall not commence the requested action
until the applicant complies with applicable Commission rules and any pre -
construction conditions established by Commission decision granting the application;
3. If a hearing is held, the applicant must present evidence at the hearing to establish its
qualifications to undertake, and its right to undertake, the requested action; and
4. In lieu of the statement contained in subparagraphs (b)(VII)(A) through(C) of this
paragraph, an applicant may include a statement that it has read, and agrees to abide
by, the provisions of subparagraphs (b)(VII)(A) through(C) of this paragraph.
CDOT acknowledges that by signing the application:
1. The filing of the application does not by itself constitute approval of the
application for the requested action;
2. If the application is granted, the applicant shall not commence the requested
action until the applicant complies with applicable Commission rules and any
pre -construction conditions established by Commission decision granting the
application;
3. If a hearing is held, the applicant must present evidence at the hearing to
establish its qualifications to undertake, and its right to undertake, the requested
action; and
4. In lieu of the statement contained in subparagraphs (b)(VII)(A) through(C) of
this paragraph, an applicant may include a statement that it has read, and
agrees to abide by, the provisions of subparagraphs (b)(VII)(A) through(C) of
this paragraph.
I. Rule 7002(b)(IX)
An attestation which is made under penalty of perjury; which is signed by an officer, a
partner, an owner, an employee of, an agent for, or an attorney for the applicant, as
appropriate, who is authorized to act on behalf of the applicant; and which states that the
contents of the application are true, accurate, and correct. The application shall contain
the title and the complete address of the affiant.
See attached Affidavit.
3
II. Information Required j Rule 7204(a)
A. Rule 7204(a)(I) - All crossing applications shall contain the following
information:
1. The contact person name, mailing address and e-mail address to whom the
Commission notice is to be sent:
a) If the application is filed by a road authority, provide the above information
for each railroad, railroad corporation, rail fixed guideway, or transit agency
that owns the tracks affected by an application.
Lance Kippen
Manager Special Projects
Union Pacific Railroad
1400 West 52nd Avenue
Denver, CO 80221
b) If the application is filed by a railroad, railroad corporation, rail fixed
guideway, transit agency, or other person, firm, or corporation that will own
the tracks, provide the above information for each road authority that owns the
roadway affected by the application.
N/A
2. The railroad and/or rail fixed guideway line name and milepost number where the
crossing that is subject of the application is located.
Union Pacific Railroad, Denver Division, Greeley Sub, MP 74.29
3. The National Inventory Number and the National Inventory Form for an existing
crossing, or a statement that no National Inventory Number and/or National Inventory
Form exists for a new crossing.
National Inventory Number 804865C, See attached Exhibit A.
4. All accident reports for the crossing and/or a listing of all accidents for any rail fixed
guideway tracks through the crossing, or a statement that no accident reports and/or
listing of rail fixed guideway accidents exist for the crossing.
No FRA reported accident reports exist for this crossing.
5. A statement of the date that the required crossing safety diagnostic occurred, or a
copy of written correspondence from Commission staff that a crossing safety
diagnostic was not required.
The required crossing safety diagnostic occurred on September 7, 2017.
6. A statement of:
4
a) The existing number and character of trains (e.g., through movements,
switching movements) passing through the crossing each day if the National
Inventory Form has not been updated within three years from the date of the
filing of the application, or the existing number, character, and timetable
speed of trains as shown on the National Inventory Form if the form has been
updated within three years from the date of the filing of the application;
Total Day Thru Trains: 7
Total Night Thru Trains: 7
Total Switching Trains: 0
b) The five-year projection of increases or decreases of the number and
character of trains using the crossing; and
No anticipated increases or decreases in the number or character of
trains is known at this time.
c) The maximum timetable speed of trains using the crossing.
Maximum Timetable Speed: 60 MPH
7. A detailed statement as to the nature of and need for the construction, alteration,
abolition, installation, or modification for which approval is sought.
County Road 104 is being closed as part of a collective agreement between
CDOT, Weld County and UPRR to allow CDOT to purchase necessary
right-of-way for the US 85 corridor. CDOT has appropriated Federal
Section 130 Funds for removal of the existing passive warning signs and
crossing surface, and removal of the roadway approaches in accordance
with the diagnostic team recommendations.
8. A statement of the scope of the project, including without limitation:
a) The highway design, pathway design, crossing warning devices, and
necessary traffic signal interconnection and preemption;
The project includes removal of passive warning signs and crossing
surface, removal of existing roadway approaches, and construction of a
cul-de-sac west of the crossing. Signing along the county road and along
US 85 that will no longer be valid will be removed.
b) The detailed itemized estimated cost of the proposed construction, alteration,
abolition, or highway -rail or pathway crossing warning device installation or
modification;
5
The detailed itemized estimated cost of the railroad work items is
included in the attached
c) How the applicant proposes to provide for the cost, explaining the proposed
apportionment between or among the parties in interest if applicable; and
The cost for crossing removal will be funded through appropriation of
Federal Section 130 Funds.
d) If the funds necessary for the project are currently available and encumbered.
The funds necessary for the project are currently available and
encumbered.
9. A statement of the estimated month and year for:
a) The start date for the construction, alteration, abolition, or crossing warning
device installation or modification;
The estimated start date of construction is:
June 1, 2018
b) The completion date for the construction, alteration, abolition, or crossing
warning device installation or modification; and
The estimated completion date of construction is:
August 20, 2018
c) The date for commencement of operations through the crossing for new
crossings.
N/A
10. A vicinity map that includes the proposed project limits (i.e., a map that includes the
general area circumscribing the project).
A Vicinity Map is provided as attached Exhibit C.
11. The names and mailing addresses of all persons, including adjacent property owners,
public utilities, and local government agencies that may be interested in or affected by
the application.
Property Owners:
No.
Owner Name
Mail
Address
City
State
Zip
80221
1
Union Pacific Railroad
1400 West 52°d
Avenue
Denver
CO
2
Karl
& Janet
Kerzic
57 Woodland
Circle
Highlands
Ranch
CO
80126
Property Owners: (con't
No.
Owner Name
Mail Address
City
State
Zip
3
Jerry & Tammy Elley
13689 CR 104
Nunn
CO
80648
4
Michael Palmer
1119 E 16th Street
Loveland
CO
80538
5
Charles & Debra Crew
13679 CR 104
Nunn
CO
80648
6
Craig Thompson
262 30`h Avenue
Greeley
CO
80631
7
John & Christine
Dibenedetto
P.O. Box 1236
Fort
Collins
CO
80522
8
Coby & Teresa Ford
13141 CR 104
Nunn
CO
80648
9
Ike & Lurena King
13141 CR 104
Nunn
CO
80648
10
Rouse Farms Co LP
15627 CR 108
Nunn
CO
80648
11
Weld County
P.O. Box 758
Greeley
CO
80632
Utility Owners:
UTILITY
ADDRESS
PHONE
Fiber
ATT Transmission
5225 Zuni Street, Denver, CO 80221
800-252-1133
Tele-Nunn Telephone
285 Logan Avenue, Nunn, CO 80648
970-897-2300
CenturyLink Fiber &
Telephone
280 West 62"d Avenue, Denver, CO 80216
800-778-9140
Sprint
3000 East 1St Avenue, Suite 295, Denver, CO
80206
800-521-0579
Zayo Bandwidth - 360
• Networks
12101 Airport Way, Broomfield, CO 80021
443-403-2023
Level 3
Communications
1025 Eldorado Blvd., Broomfield, CO 80021
877-366-8344
Electric/Gas, .
Xcel Energy 1 1500 6th Avenue, Greeley, CO 80631 970-800-3665
12. If the crossing is at -grade: a statement fully justifying why a separation of grades is
not practicable under the circumstances.
N/A
13. A statement if the application is seeking preliminary approval of conceptual level
design plans, or if the application is seeking final approval of final design plans.
CDOT is seeking final approval of final design with this application.
14. A statement if the application includes a request to install a temporary safety measure.
N/A
7
B. Rule 7204(a)(II) - Applications for all highway -rail crossings shall include:
1. The existing ADT volume and character of vehicles (including, but not limited to
estimated percentage of heavy vehicles and a statement about whether school buses
use the crossing) passing through the highway -rail crossing each day if the traffic
volume on the National Inventory Form has not been updated within three years from
the date of the filing of the application, or the existing ADT volume and character of
vehicles passing through the highway -rail crossing each day as shown on the National
Inventory Form if the traffic volume on the form has been updated within three years
from the date of the filing of the application. If the ADT volume has not been
updated within three years from the date of the filing of the application, the road
authority will be responsible for paying for the cost of the updated ADT count;
Existing ADT: 100 (2016)
Character of Vehicles:
% Trucks: 0%
School buses do not use this crossing.
2. The five --year and twenty-year ADT volume projections of vehicles using the
highway -rail crossing; and
5 -Year Projected ADT: 110
20 -Year Projected ADT: 150
3. The posted or unposted speed limit for the vehicles traveling through the highway -rail
crossing.
Posted/Unposted Speed: 55 MPH
C. Rule 7204(a)(III) - Applications for all pathway crossing shall include:
1. The existing or estimated number of pedestrians and bicycles passing through the
pathway crossing each day and a statement if the number is based on an actual count
or an estimate; and
N/A
2. The five-year and twenty-year projections of the number of pedestrians and bicycles
using the pathway crossing.
N/A
D. Rule 7204(a)(IV) - Applications that include a request for temporary safety
measures filed pursuant to paragraph 7203(1) shall include:
1. A statement of the temporary safety measure being sought;
8
N/A
2. Schematic plans of the temporary measure to be implemented;
N/A
3. The diagnostic notes including a list of all in attendance;
N/A
4. A statement that the diagnostic team is in consensus with the temporary safety
measure being sought;
N/A
E. Rule 7204(a)(V) - Applications for preliminary of final approval of new at -
grade crossing shall include:
1. Detailed plans/drawings of a suitable scale, showing the at -grade crossing, including
signing and striping, tracks, buildings, structures, property lines, and public highways
within the right-of-way limits of the railroad, railroad corporation, rail fixed
guideway, rail fixed guideway system, or transit agency;
N/A
2. A profile drawing showing grade lines and proposed grade lines of approaches on the
public highway or pathway, and the tracks being crossed that may be affected by the
proposed or existing crossing;
N/A
3. Proposed roadway classification (e.g., local road, collector, arterial, freeway) and a
cross-section drawing of the road authority's standards for that roadway classification
or cross-section drawing of the pathway;
N/A
4. The following documentation for all existing crossings within one -mile of the
proposed location of the new crossing in urban locations or within towns, or the two
crossings nearest the proposed crossing in rural locations:
a) The National Inventory Number and National Inventory Form;
N/A
b) All accident reports or a statement that no accident reports are available; and
N/A
9
c) The existing ADT volume and character of vehicles (including, but not limited
to, estimated percentage of heavy vehicles and a statement about whether
school buses use the crossing) passing through the highway -rail crossing each
day if the traffic volume on the National Inventory Form has not been updated
within three years from the date of the filing of the application, or the existing
ADT volume and character of vehicles passing through the highway -rail
crossing each day as shown on the National Inventory Form if the traffic
volume on the form has been updated within three years from the date of the
filing of the application. If the ADT volume has not been updated within
three years from the date of the filing of the application, the road authority
will be responsible for paying for the cost of the updated ADT count.
N/A
F. Rule 7204(a)(VI) - Applications for preliminary or final approval to widen,
narrow, or relocate an existing crossing shall include:
1. Detailed plans/drawings of a suitable scale, showing the grade crossing, including
signing and striping, tracks, buildings, structures, property lines, and public highways
within the right-of-way limits of the railroad, railroad corporation, rail fixed
guideway, rail fixed guideway system, or transit agency;
N/A
2. A profile drawing showing grade lines and proposed grade lines of approaches on the
public highway or pathway and the tracks being crossed that may be affected by the
proposed or existing crossing;
N/A
3. Existing roadway classification (e.g., local, collector, arterial, freeway) and a cross-
section drawing of the roadway authority's standards for that roadway classification
or cross-section drawing of the pathway; and
N/A
5. Proposed roadway classification (e.g., local road, collector, arterial, freeway) and a
cross-section drawing of the roadway authority's standards for that roadway
classification or cross-section drawing of the pathway.
N/A
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G. Rule 7204(a)(VII) - Applications for preliminary or final approval to close a
crossing by removal of the tracks shall include:
1. Detailed plans/drawings of a suitable scale, showing the details of the crossing
closure plan;
N/A
2. A copy of the notice of proposed closure of the crossing as required under paragraph
7208(c); and
N/A
3. Traffic volumes under (II) are not required.
N/A
H. Rule 7204(a)(VIII) - Applications to close a crossing by removal of the roadway
or pathway shall include:
1. The following documentation for all existing crossings within one -mile of the
proposed location of the crossing to be closed in urban locations or within towns, or
the two crossings nearest the proposed crossing to be closed in rural locations:
a) The National Inventory Number and National Inventory Form;
Nearest two crossings:
DOT 804866J— US 85, National Inventory Form provided as Exhibit D.
DOT 804867R — CR 100, National Inventory Form provided as Exhibit E.
b) All accident reports or a statement that no accident reports are available; and
Nearest two crossings:
There are no FRA Accident Reports for DOT 804866J— US 85.
There are no FRA Accident Reports for DOT 804867R — CR 100.
c) The existing ADT volume and character of vehicles (including, but not limited
to, estimated percentage of heavy vehicles and a statement about whether
school buses using the crossing) passing through the highway -rail crossing
each day if the traffic volume on the National Inventory Form has not been
updated within three years from the date of the filing of the application, or the
11
existing ADT volume and character of vehicles passing through the highway -
rail crossing each day as shown on the National Inventory Form if the traffic
volume on the form has been updated within three years from the date of the
filing of the application. If the ADT volume has not been updated within
three years from the date of the filing for the application, the road authority
will be responsible for paying for the cost of the updated ADT count.
DOT 804866J— US 85
Existing APT: 5400 (2016)
Character of Vehicles:
% Trucks: 13%
School buses dnot se this crossings
D �,T 804:;67R - CR 100
Existing ADT: 30 (2016)
Character of Vehicles:
`t// Trucks: 5%
School buses do not t k se Lis is crossing.
2. Detailed plans/drawings of a suitable scale showing the details of the crossing closure
plan; and
Detailed Plans for the crossing closure re provided in
3. The notice of proposed closure of the crossing as required under paragraph 7208(c).
A copy of the Notice of k' ropsed Closure of the crossing is provided as Exhibit
G.
Im Rule 7204(a)(IX) - Applications f r preli 'nary or final approval to install or
change passive warning devices at crossings shall inclue:
1. A description of the type of warning device the applicant proposes to install; and
N/A
2. Detailed railroad cost estimate of the crossing warning devices.
N/A
J. Rule 7204(a)(X) Applicatins for preliminary or final approval for installation
of new active warning evices, replacement f existing active warning devices, or
replacement of existing train detection circuitry at crossings shall include:
1. Detailed plans/drawings of a suitable scale, showing the crossing, including signing
and striping, tracks, buildings, structures, property lines, and public highways within
12
the right-of-way limits of the railroad, railroad corporation, rail fixed guideway, rail
fixed guideway system, or transit agency;
N/A
2. A description of the type of warning devices the applicant proposes to install
(reference may be made to recommended standards on highway -rail grade crossing
warning devices as published in current editions of the MUTCD and/or the American
Railway Engineering and Maintenance -of -Way Association's Signal Manual of
Recommended Practice);
N/A
3. The detailed railroad cost estimate of the crossing warning devices; and
N/A
4. The schematic diagram of the crossing warning devices (commonly referred to as the
"front sheet") and shall specifically identify the equipment response time, advanced
preemption time, minimum warning time, clearance time, buffer time, and total
warning time).
N/A
5. A description of the type of four quadrant exit gate operating mode proposed (e.g.,
timed, dynamic exit gate vehicle detection, or timed/dynamic combination);
N/A
K. Rule 7204(a)(XI) - Applications for preliminary or final approval involving
installation of four quadrant gate active warning devices shall include:
1. A description of the type of four quadrant exit gate operating mode proposed (e.g.,
timed, dynamic exit gate vehicle detection, or timed/dynamic combination);
N/A
2. For timed exit gate operating mode, the proposed exit gate clearance time, a
description of the methodology used to determine the exit gate clearance time and the
calculations performed to determine the exit gate clearance time;
N/A
3. For dynamic exit gate operating mode, a description of the type of vehicle detection
proposed, a plan/drawing showing the proposed vehicle detector placement(s) and
description and timings of how the vehicle detection will operate; and
13
N/A
5. A letter of concurrence from Commission staff regarding the proposed four -quadrant
operations and timings, or a statement that Commission staff does not concur with the
proposed four -quadrant operations and timings.
N/A
L. Rule 7204(a)(XII) - Applications for preliminary or final approval involving
interconnection to traffic signals or queue cutter signals and preemption by
active warning signals shall include:
1. A statement of the proposed preemption operations (e.g., simultaneous, advanced);
N/A
2. The traffic signal timings, including:
a) The traffic signal cycle length;
N/A
b) Minimum green time for each signal phase and pedestrian phase;
N/A
c) Green times for each signal phase;
N/A
d) Yellow change times for each signal phase;
N/A
e) Red clearance times for each signal phase;
N/A
f) Walk times for each pedestrian phase;
N/A
g) Flashing don't walk times for each pedestrian phase;
N/A
h) The traffic signal phasing diagram including the preemption sequence; and
14
N/A
i) A statement of whether and what type of gate down circuitry will be used.
N/A
3. A list of and calculations for the following distances and timings:
a) Minimum track clearance distance;
N/A
b) Design vehicle designation and length;
N/A
c) Clear storage distance;
N/A
d) Preemption delay time;
N/A
e) Controller response time to preemption call;
N/A
f) Worst case conflicting vehicle time and worst case conflicting pedestrian time;
N/A
g) Maximum highway traffic signal preemption time;
N/A
h) Right-of-way transfer time;
N/A
i) Queue clearance time;
N/A
j) Clearance time;
N/A
15
k) Separation time;
N/A
1) Advance preemption time;
N/A
m)Minimum warning time.
N/A
4. A letter of concurrence from Commission staff regarding the proposed preemption
operations and timings, or a statement that Commission staff does not concur with the
proposed preemption operations and timings.
N/A
M. Rule 7204(a)(XII) - Applications requesting cost allocation to the Highway -Rail
Crossing Signalization Fund or projects for which the Colorado Department of
Transportation has appropriated Federal Section 130 Fund shalt contain:
1. Specific information regarding the requested apportionment of costs between the
railroad, railroad corporation, rail fixed guideway, rail fixed guideway system, or
transit agency, the road authority, and the Highway -Rail Crossing Signalization Fund
or Federal Section 130 Fund.
The apportionment of costs is as follows:
Union Pacific Railroad (Railroad): $0
Weld County (Road Authority): SO
Federal Section 130 Fund:
$xxx,xxxm00
N. Applications for preliminary or final approval to change an existing crossing
from a public crossing to a private crossing shall include:
1. The following documentation for all existing crossings within one -mile of the
proposed location of the new crossing in urban locations or within towns, or the two
crossings nearest the proposed crossing in rural locations:
a) The National Inventory Number and National Inventory Form;
N/A
b) Copies of all accident reports or a statement that no accident reports are
available for those crossings; and
N/A
16
c) The existing ADT volume and character of vehicles passing through the
highway -rail crossing each day if the traffic volume on the National Inventory
Form has not been updated within three years from the date of the filing of the
application, or the existing ADT volume and character of vehicles passing
through the highway -rail crossing each day as shown on the National
Inventory Form if the traffic volume on the form has been updated within
three years from the date of the filing of the application.
N/A
2. Documentation (ordinance, ruling, etc.) showing that the road authority agency is
proposing to remove the road from its network of ownership, operation, and
maintenance; and
N/A
3. Documentation showing the person that will be owning, operating, and maintaining
the private roadway.
N/A
O. Rule 7204(a)(XV) - Applications for preliminary or final approval to change an
existing crossing from a private crossing to a public crossing shall include:
1. Proposed roadway classification (e.g., local road, collector, arterial, freeway) and a
cross-section drawing of the road authority's standards for that roadway classification
or cross-section of the pathway;
N/A
2. A statement that the existing crossing meets the standards of the proposed roadway
classification or a statement that the roadway will be changed to meet the current
roadway classification standards; and
N/A
3. Documentation (ordinance, ruling, etc.) showing that the road authority is accepting
the road into its network for ownership, operation, and maintenance;
N/A
P. Rule 7204(a)(XVI) - Applications for preliminary or final approval to construct a
grade separated crossing shall include:
1. Detailed plans/drawings of a suitable scale, showing the crossing, including signing
and striping, tracks, buildings, structures, property lines, and public highways within
17
the right-of-way limits of the railroad, railroad corporation, rail fixed guideway, rail
fixed guideway system, or transit agency;
N/A
2. A profile drawing showing grade lines and proposed grade lines of approaches on the
public roadway, highways, streets, or pathways and the tracks being crossed that may
be affected by the proposed or existing crossing;
N/A
3. Bridge plan/drawings that show, at a minimum:
a) The total length of the bridge structure;
N/A
b) The length of each individual span for multiple span bridge structures;
N/A
c) The location of all existing and any possible proposed future tracks in relation
to the bridge structure;
N/A
d) The minimum vertical clearance from the top of rail or pavement to the
bottom of structure;
N/A
e) The minimum horizontal clearance from centerline of track to face of pier or
abutment if track is under the bridge structure; and
N/A
fj The cross-section of the bridge showing information regarding the roadway,
pathway, or railroad configuration including, but not limited to, out -to -out
distance, fencing, lane widths, walkway widths, and median widths.
N/A
Q. Rule 7204(a)(XVII) - Applications for any preliminary approval of
plans/drawings shall include:
1. The date by which all final plans/drawings for which preliminary or conceptual level
plans/drawings were provided with the application will be filed for approval; and
18
N/A
2. A waiver of the applicable statutory period I §40-6-109.5, C.R.S. regarding the time
limit for decisions.
N/A
R. Rule 7204(a)(XVIII) - Applications for a utility crossing shall include:
1. The contact person name, mailing address and e-mail address to whom the
Commission notice is to be sent:
a) For each railroad, railroad corporation, rail fixed guideway, or transit agency
that owns the tracks affected by an application filed by a utility; and
N/A
b) For each utility affected by the application filed by a railroad, railroad
corporation, rail fixed guideway, transit agency, or other person, firm, or
corporation that will own the tracks affected by the application.
N/A
2. The railroad and/or rail fixed guideway line name and milepost number where the
crossing that is subject of the application is located;
N/A
3. A detailed statement as to the nature of and need for the construction, alternation,
abolition, installation, or modification for which approval is sought;
N/A
4. A statement of the scope of the project, including without limitation:
a) The utility construction location;
N/A
b) The detailed itemized estimated cost of the proposed utility crossing
construction, alteration, abolition, or modification;
N/A
c) How the applicant proposes to provide for the cost, explaining the proposed
apportionment between or among the parties in interest if applicable; and
N/A
19
d) If the funds necessary for the project are currently available and encumbered.
N/A
5. A statement of the estimated month and year for:
a) The start date for the utility crossing construction, alteration, abolition, or
modification; and
N/A
b) The completion date for the utility crossing construction, alteration, abolition,
or modification.
N/A
6. A vicinity map that includes the proposed project limits (i.e., a map that includes the
general area circumscribing the project);
N/A
7. The names and mailing addresses of all persons, including adjacent property owners,
public utilities, and local government agencies that may be interested in or affected by
the application:
N/A
8. Detailed plans/drawings of a suitable scale, showing the utility crossing, tracks,
buildings, structures, and property lines within the right-of-way limits of the railroad,
railroad corporation, rail fixed guideway, rail fixed guideway system, or transit
agency; and
N/A
9. A profile drawing showing grade lines and proposed grade lines of the utility in
relation to the tracks being crossed.
N/A
III. Information Required la Rule 7205
A. Additional Application Contents for Cost Allocation Requests in Grade
Separation Applications.
1. In the case of applications concerning highway -rail grade separations for which
contribution from one or more railroad corporations is requested, the applicant shall,
in addition to the information required by paragraph 7204(a), include the following
20
additional information in the application in the following order and specifically
identified either in the application or appropriately identified attachments:
a) A complete description of the scope of the proposed separation project;
N/A
b) A preliminary set of construction plans, including engineering costs;
N/A
c) A Preliminary engineer's cost estimate, including engineering costs;
N/A
d) The estimated costs of right-of-way, parcel by parcel, including railroad right-
of-way;
N/A
e) A proposed construction timetable;
N/A
f). A list of affected railroad corporations;
N/A
g) A Preliminary design of the theoretical structure for a reasonably adequate
facility; and
N/A
h) A cost estimate of the theoretical structure, including the costs described in
subparagraphs (III) and (IV) of this paragraph and including a 20 percent
contingency.
N/A
2. The railroad and/or rail fixed guideway line name and milepost number where the
crossing that is subject of the application is located.
N/A
3. The National Inventory Number and the National Inventory Form for an existing
crossing, or a statement that no National Inventory Number and/or National Inventory
Form exists for a new crossing.
21
N/A
4. All accident reports for the crossing and/or a listing of all accidents for any rail fixed
guideway tracks through the crossing, or a statement that no accident reports and/or
listing of rail fixed guideway accidents exist for the crossing
N/A'
5. A statement of the date that the required crossing safety diagnostic occurred, or a
copy of written correspondence from Commission staff that a crossing safety
diagnostic was not required.
N/A
6. A statement of:
a) The existing number and character of trains (e.g., through movements,
switching movements) passing through the crossing each day if the National
Inventory Form has not been updated within three years from the date of the
filing of the application, or the existing number, character, and timetable
speed of trains as shown on the National Inventory Form if the form has been
updated within three years from the date of the filing of the application;
N/A
b) The five-year projection of increases or decreases of the number and
character of trains using the crossing; and
N/A
c) The maximum timetable speed of trains using the crossing.
N/A
7. A detailed statement as to the nature of and need for the construction, alteration,
abolition, installation, or modification for which approval is sought.
N/A
8. A statement of the scope of the project, including without limitation:
a) The highway design, pathway design, crossing warning devices, and
necessary traffic signal interconnection and preemption;
N/A
22
b) The detailed itemized estimated cost of the proposed construction, alteration,
abolition, or highway -rail or pathway crossing warning device installation or
modification;
N/A
c) How the applicant proposes to provide for the cost, explaining the proposed
apportionment between or among the parties in interest if applicable; and
N/A
d) If the funds necessary for the project are currently available and encumbered.
N/A
9. A statement of the estimated month and year for:
a) The start date for the construction, alteration, abolition, or crossing warning
device installation or modification;
N/A
b) The completion date for the construction, alteration, abolition, or crossing
warning device installation or modification; and
N/A
c) The date for commencement of operations through the crossing for new
crossings.
N/A
10. A vicinity map that includes the proposed project limits (i.e., a map that includes the
general area circumscribing the project).
N/A
11. The names and mailing addresses of all persons, including adjacent property owners,
public utilities, and local government agencies that may be interested in or affected by
the application.
N/A
12. If the crossing is at -grade: a statement fully justifying why a separation of grades is
not practicable under the circumstances.
N/A
23
13. A statement if the application is seeking preliminary approval of conceptual level
design plans, or if the application is seeking final approval of final design plans
N/A
14. A statement if the application includes a request to install a temporary safety measure.
N/A
24
WHEREFORE, CDOT requests that the Public Utilities Commission enter an Order
authorizing the removal of existing passive warning signs and crossing surface, and removal of
roadway approaches to close the existing County Road 104 crossing of UPRR tracks for which
CDOT has appropriated Federal Section 130 Funds in Weld County, State of Colorado.
DATED at Denver, Colorado this day of , 2018.
DEPARTMENT OF TRANSPORTATION
STATE OF COLORADO
By
Joshua Laipply, P.E.
Chief Engineer
By
Gregg E. Carson, #25460
Attorney for the Colorado Department of Transportation
Litigation & Employment Section -Transportation Unit
1300 Broadway, 10th Floor
Denver, CO 80203
Ph. 720-508-6000
Email: Gregg.Carson@coag.gov
25
ATTESTATION
The undersigned is authorized to act on behalf of the applicant and attests, as required
and pursuant to Commission Rule 4 Code of Colorado Regulations 723-7-7002(b)(IX), that [s]he
has read the foregoing Application and states, under penalty of perjury, that all facts regarding
this Application are true and correct to his/her best personal knowledge, information and belief.
Neil Lacey, PE
Resident Engineer
Colorado Department of Transportation
4201 East Arkansas Avenue, 4th Floor
Denver, CO 80222
STATE OF COLORADO )
)ss
COUNTY OF DENVER )
Subscribed and sworn to before me this day of , 2018
Notary Public
--My Commission expires on
26
SECTION 130 WO ti _:.. PRO
OSAL
SECTION 130 SUPPLEMENT TO MASTER AGREEMENT
FROM UNION PACIFIC RAILROAD COMPANY
TO STATE OF COLORADO ACTING BY AND THROUGH COLORADO DEPARTMENT OF
TRANSPORTATION TO
FOR EXISTING GRADE CROSSING IMPROVEMENT PROJECTS
CDOT
Project Name:
County Road 104, Nunn,
RR Crossing Closure
CDOT
Project No
(the "Project"):
<insert
proj.
no., insert proj. code>
DOT Number(s):
804-865C
Railroad
Subdivision:
Greeley
Subdivision
Railroad
Milepost
Number(s):
74.29
Highway(s), Road(s)
"Crossing"):
or Street(s)
(the
CR
104
W of US 85
City:
�.,i
unn
County:
Weld
A) Union Pacific Railroad Company ("Railroad") and the State of Colorado acting by and through the
Department of Transportation ("CDOT") entered into a Master Agreement for at -grade public highway
crossings on the Railroad's tracks with roadway rights of way that require safety improvements ("Master
Agreement") dated March 1, 2012, CMS #12HAA40760 as amended, Railroad Audit No. 262699. Railroad
and CDOT are collectively identified as the "Parties."
B) As provided in the Master Agreement, CDOT and Railroad are to enter into supplements to the Master
Agreement covering each specific existing at -grade crossing improvement project.
C) This Section 130 supplement to the Master Agreement ("Section 130 Supplement") is proposed by the
Railroad to provide for the Project improvements described in this Section 130 Supplement, which are to be
completed at the Crossing described above pursuant to the terms and conditions of the Master Agreement
and this Section 130 Supplement.
D) Listed below are the proposed improvements with cost estimates. CDOT's detailed plan is attached as
Exhibit 1 and made a part of this Section 130 Supplement. The Railroad's force account estimate(s) and
wiring diagram(s) (if required) are attached as Exhibit 2 and made a part of this Section 130 Supplement.
F) Description of Project improvements (the "Project Improvements"):
Remove existing passive warning signs and crossing surface (Railroad). Remove approach from US 85 to
the east, but retain right -in -right -out for landowner; remove approach to the west and construct cul-de-sac
(CDOT).
F) Railroad estimates that the Project Improvements will be:
Estimated
Cost
Total
Federal
Funds
State
Funds
Local
Funds
Railroad
Funds
$0
$0
$0
Sxxx,xxx
$xxx,xxx
1
G) Upon CDOT's execution of a Supplement (as defined in the Master Agreement) for the Project
Improvements, CDOT's payment and Railroad's performance for the Project Improvements shall be made
pursuant to the provisions of the Master Agreement. Railroad will refer to CDOT's project number
(identified above) and shall forward Invoices to CDOT pursuant to the Master Agreement.
H) This Section 130 Supplement is the complete proposal from the Railroad for the Project Improvements for
the Project identified above and may be modified by written amendment only, signed by Railroad.
RAILROAD:
Union Pacific Railroad Company
By:
Print Name of Authorized Individual:
Print Title of Authorized Individual:
Date:
2
Exhibit 1 to Section 130 Supplement
CDOT's Project plan sheets
Exhibit 2 to Section 130 Supplement
Railroad's estimate(s) and signal wiring diagram(s), if applicable
U. S. DOT CROSSING INVENTORY FORM
EXHIBIT A
DEPARTMENT OF TRANSPORTATION
FEDERAL RAILROAD ADMINISTRATION
OMB No. 2130-0017
Instructions for the initial reporting of the following types of new or previously unreported crossings: For public highway -rail grade crossings, complete the entire inventory
Form. For private highway -rail grade crossings, complete the Header, Parts I and II, and the Submission Information section. For public pathway grade crossings (including
pedestrian station grade crossings), complete the Header, Parts I and II, and the Submission Information section. For Private pathway grade crossings, complete the Header,
Parts I and II, and the Submission Information section. For grade -separated highway -rail or pathway crossings (including pedestrian station crossings), complete the Header, Part
I, and the Submission Information section. For changes to existing data, complete the Header, Part I Items 1-3, and the Submission Information section, in addition to the
updated data fields. Note: For private crossings only, Part I Item 20 and Part III Item 2.K. are required unless otherwise noted. An asterisk * denotes an optional field.
A. Revision Date
(MM/DD/YWY)
11 / 16 / 2017
B. Reporting Agency
N Railroad O Transit
❑ State O Other
C. Reason for Update (Select only one)
g Change in ❑ New O Closed O No Train O Quiet
Data Crossing Traffic Zone Update
O Re -Open O Date O Change in Primary ❑ Admin.
Change Only Operating RR Correction
D. DOT Crossing
Inventory Number
804865C
,Part I: Location and Classification Information
1. Primary Operating Railroad
Union Pacific Railroad Company [UP]
2. State
COLORADO
3. County
WELD
4. City / Municipality -
OI
® Near NUNN
5. Street/Road Name & Block Number
CR104 I
6. Highway Type & No.
NA
(Street/Road Name) I • (Block Number)
7. Do Other Railroads Operate a Separate Track at Crossing? O Yes Ed No
If Yes, Specify RR
8. Do Other Railroads Operate OverYour Track at Crossing? O Yes ® No
If Yes, Specify RR •
9. Railroad Division or Region
o None DENVER
10. Railroad Subdivision or District
O None Greeley
11. Branch or Line Name
RI None
12. RR Milepost
0074.290 i
(prefix) I (nnnn.nnn) I (suffix)
13. Line Segment
•
14. Nearest RR Timetable
Station •
15. Parent RR (if applicable)
®N/A
16. Crossing Owner (if applicable)
NI N/A
17. Crossing Type
® Public
❑ Private
18. Crossing Purpose
a Highway
O Pathway, Ped.
O Station, Ped.
19. Crossing Position
® At Grade
❑ RR Under
❑ RR Over
20. Public Access
(if Private Crossing)
O Yes
O No
21. Type of Train
la Freight O Transit
❑ Intercity Passenger O Shared Use Transit
❑ Commuter O Tourist/Other
22. Average Passenger
Train Count Per Day
O Less Than One Per Day
❑ Number Per Day 0
23. Type of Land Use
NI Open Space O Farm ❑ Residential . O Commercial ❑ Industrial. O Institutional ❑ Recreational O RR Yard
24.1s there an Adjacent Crossing with a Separate Number?
❑ yes NI No If Yes, Provide Crossing Number
25. Quiet Zone (FRA provided),'
' IJ;,No . O 24 Hr , ❑ Partial, r. O Chicago Excused: i ., Date Established -
26. HSR Corridor ID
® N/A
27. Latitude in decimal degrees
(WGS84 std: nn.nnnnnnn) .40.7394094
28. Longitude in decimal degrees
(WG584 std: -nnn.nnnnnnn)-104.7931239
29. Lat/Long Source
® Actual ❑ Estimated
30.A. Railroad Use •
31.A. State Use •
30.B. Railroad Use •
31.B. State Use •
30.C. Railroad Use *
31.C. State Use •
30.D. Railroad Use •
31.D. State Use •
32.A. Narrative (Railroad Use) •
32.B. Narrative (State Use) • '
33. Emergency Notification Telephone No. (posted)
800-848-8715
34. Railroad Contact (Telephone No.)
402-544-3721
35. State Contact (Telephone No.)
303-757-9425
Part II:_RailroadInformation .
1. Estimated Number of Daily Train Movements
1.A. Total Day Thru Trains
(6 AM to 6 PM)
7
1.8. Total Night Thru Trains
(6 PM to 6 AM)
7
1.C. Total Switching Trains
0
1.D. Total Transit Trains
0
1.E. Check if Less Than
One Movement Per Day ❑
How many trains per week?
2. Year of Train Count Data (YYYY)
2016
3. Speed of Train at Crossing
3.A. Maximum Timetable Speed (mph) 60
3.8. Typical Speed Range Over Crossing (mph) From 30 ' to 60
4. Type and Count of Tracks
Main 1 Siding° Yard 0 Transit 0 Industry 0
5. Train Detection (Main Track only)
❑ Constant Warning Time O Motion Detection ❑AFO O PTC O DC ® Other ❑ None
6. Is Track Signaled? -
® Yes O No
7.A. Event Recorder
❑ Yes RI No
7.8. Remote Health Monitoring
❑ Yes ® No
FORM FRA F 6180.71 (Rev. 3/15)
OMB approval expires 3/31/2018
Page 1 OF 2
EXHIBIT A
U. S. DOT CROSSING INVENTORY FORM
A. Revision Date (MM/DD/YYYY) I
11/16/2017
PAGE 2 I
D. Crossing Inventory Number (7 char.)
804865C
. ' Part III:.:Highway or' Pathway Traffic Control Device Information `
1. Are there
Signs or Signals?
Yes ❑ No
2. Types of Passive Traffic Control Devices associated with the Crossing
2.A. Crossbuck
Assemblies (count)
2.B. STOP Signs (R1-1)
(count)
2.C. YIELD Signs (R1-2)
(count)
2.D. Advance Warning Signs (Check all that apply; include count) O None
l W10-1 ❑ W10-3 O W10-11
2 -
2
O W10-2 O W10-4 O W10-12
2.E. Low Ground Clearance Sign
(W10-5)
O Yes (count 0 )
2.F. Pavement Markings
• -
O Stop Lines ODynamic Envelope
O RR Xing Symbols N None
2.G. Channelization
Devices/Medians
O All Approaches O Median
O One Approach O None
2.H. EXEMPT Sign
(R15-3)
O Yes
g No
2.1. ENS Sign (1-13)
Displayed
E] Yes
O No
E No
2.J. Other MUTCD Signs O Yes g No
Specify Type Count 0
2.K. Private Crossing
Signs (if private)
O Yes O No
2.L. LED Enhanced Signs (List types)
Specify Type Count 0
Specify Type Count
3. Types of Train Activated Warning Devices at the Grade Crossing (specify count of each device for all that apply)
3.A. Gate Arms
(count)
Roadway 0
3.B. Gate Configuration
.
O 2 Quad O Full (Barrier)
O 3 Quad Resistance
O 4 Quad O Median Gates
3.C. Cantilevered (or Bridged) Flashing Light
Structures (count)
Over Traffic Lane 0 O Incandescent
3.D. Mast Mounted Flashing Lights
(count of masts) 0
3.E. Total Count of
Flashing Light Pairs
0
O Incandescent O LED
O Back Lights Included O Side Lights
Included
Not Over Traffic Lane 0 O LED
Pedestrian
3.F. Installation Date of Current
Active Warning Devices: (MM/YYYY)
Not Required
3.G. Wayside Horn
O Installed on (MM/YYYY) /
3.H. Highway Traffic Signals Controlling
Crossing
O Yes ® No
3.1. Bells
(count)
0
No
3.J. Non -Train Active Warning
❑ Flagging/Flagman ❑Manually Operated Signals O Watchman O Floodlighting O None
3.K. Other Flashing Lights or Warning Devices
Count 0 Specify type
4.A. Does nearby Hwy
Intersection have
Traffic Signals?
❑ Yes O No
4.8. Hwy Traffic Signal
Interconnection
O Not Interconnected
O For Traffic Signals
O For Warning Signs
. 4.C. Hwy Traffic Signal Preemption
O Simultaneous
. O Advance
5. Highway Traffic Pre -Signals
O Yes N No
Storage Distance •
6. Highway Monitoring Devices
(Check all that apply)
❑ Yes - Photo/Video Recording
O Yes— Vehicle Presence Detection
O None
Stop Line Distance •
Part IV: Physical Characteristics.
1. Traffic Lanes Crossing Railroad O One-way Traffic
O Two-way Traffic
Number of Lanes 2 O Divided Traffic
2. Is Roadway/Pathway
Paved?
- O Yes Ea No
3. Does Track Run Down a Street?
O Yes ® No
4. Is Crossing Illuminated? (Street
lights within approx. 50 feet from
nearest rail) O Yes ® No
5. Crossing Surface (on Main Track, multiple types allowed) Installation Date • (MM/YYYY) / Width' Length •
® 1 Timber O 2 Asphalt O 3 Asphalt and Timber O 4 Concrete O 5 Concrete and Rubber O 6 Rubber O 7 Metal
❑ 8 Unconsolidated O 9 Composite O 10 Other (specify)
6. Intersecting Roadway within 500 feet?
g Yes O No If Yes, Approximate Distance (feet) 75
7. Smallest Crossing Angle
O 0° - 29° O 30° - 59° ® 60° - 90°
8. Is Commercial Power Available?'
® Yes O No
Part V: Public Highway Information 4
1. Highway System
❑ (01) Interstate Highway System
❑ (02) Other Nat Hwy System (NHS)
o (03) Federal AID, Not NHS
CA (08) Non -Federal Aid
2. Functional Classification of Road at Crossing
g (0) Rural O (1) Urban
O (1) Interstate O (5) Major Collector
O (2) Other Freeways and Expressways -
O (3) Other Principal Arterial ❑ (6) Minor Collector
O (4) Minor Arterial ® (7) Local
3. Is Crossing on State Highway
System?
4. Highway Speed Limit
MPH
O Yes E9 No
El Posted O Statutory
5. Linear Referencing System (LRS Route ID) '
6. LRS Milepost •
7. Annual Average Daily Traffic (AADT)
Year 1985 AADT 50
8. Estimated Percent Trucks
00 %
9. Regularly Used by School Buses?
O Yes Ea No Average Number per Day 0
10. Emergency Services Route
O Yes O No
n Submission Information- this, infor•mation is used foradministrative.purposes'andis not available on the; public website.�
Submitted by Organization Phone Date
Public reporting burden for this information collection is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed and completing and reviewing the collection of information. According to the Paperwork Reduction Act of 1995, a federal
agency may not conduct or sponsor, and a person is not required to, nor shall a person be subject to a penalty for failure to comply with, a collection of information unless it
displays a currently valid OMB control number. The valid OMB control number for information collection is 2130-0017. Send comments regarding this burden estimate or any
other aspect of this collection, including for reducing this burden to: Information Collection Officer, Federal Railroad Administration, 1200 New Jersey Ave. SE, MS -25
Washington, DC 20590.
FORM FRA F 6180.71 (Rev. 3/15)
OMB approval expires 3/31/2018
Page 2 OF 2
Exhibit C
Print Showing Crossing Location
Project: <proj.no.>; SA:
Location Map:
Weld CR 104
<subacct>
Union Pacific Railroad
Greeley Sub
DOT Crossing #804-865C
Railroad Milepost 74.29; Lat, Long: 40.4394094, -104.7931239
Weld County
EXHIBIT D
U. S. DOT CROSSING INVENTORY FORM
DEPARTMENT OF TRANSPORTATION
FEDERAL RAILROAD ADMINISTRATION
OMB No. 2130-0017
Instructions for the initial reporting of the following types of new or previously unreported crossings: For public highway -rail grade crossings, complete the entire inventory
Form. For private highway -rail grade crossings, complete the Header, Parts I and II, and the Submission Information section. For public pathway grade crossings (including
pedestrian station grade crossings), complete the Header, Parts I and II, and the Submission Information section. For Private pathway grade crossings, complete the Header,
Parts I and II, and the Submission Information section. For grade -separated highway -rail or pathway crossings (including pedestrian station crossings), complete the Header, Part
I, and the Submission Information section. For changes to existing data, complete the Header, Part I Items 1-3, and the Submission Information section, in addition to the
updated data fields. Note: For private crossings only, Part I Item 20 and Part III Item 2.K. are required unless otherwise noted. An asterisk' denotes an optional field.
A. Revision Date
(MM/DD/YY Y)
11 / 21 / 2017
B. Reporting Agency
13 Railroad ❑ Transit
❑ State 0 Other
C. Reason for Update (Select only one)
® Change in ❑ New ❑ Closed ❑ No Train 0 Quiet
Data Crossing Traffic Zone Update
0 Re -Open 0 Date 0 Change in Primary 0 Admin.
Change Only Operating RR Correction
D. DOT Crossing
Inventory Number
804866J
Part I: Location and Classification Information
1. Primary Operating Railroad
Union Pacific Railroad Company [UP]
2. State
COLORADO
3. County
WELD
4. City / Municipality
CI In
NI Near NUNN
5. Street/Road Name & Block Number
SH85 I
6. Highway Type & No.
US 85
(Street/Road Name) I' (Block Number)
7. Do Other Railroads Operate a Separate Track at Crossing? 0 Yes ® No
If Yes, Specify RR
8. Do Other Railroads Operate Over Your Track at Crossing? ❑ Yes ® No
If Yes, Specify RR
9. Railroad Division or Region
❑ None DENVER
10. Railroad Subdivision or District
0 None Greeley
11. Branch or Line Name
RI None
12. RR Milepost
i 0074.100 i
(prefix) I (nnnn.nnn) I (suffix)
13. Line Segment
•
14. Nearest RR Timetable
Station •
15. Parent RR (if applicable)
C8 N/A
16. Crossing Owner (if applicable)
[8 N/A
17. Crossing Type
® Public
❑ Private
18. Crossing Purpose
® Highway
0 Pathway, Ped.
❑ Station, Ped.
19. Crossing Position
❑ At Grade
IR RR Under
❑ RR Over
20. Public Access
(if Private Crossing)
❑ Yes
❑ No
21. Type of Train
® Freight 0 Transit
❑ Intercity Passenger ❑ Shared Use Transit
❑ Commuter ❑ Tourist/Other
22. Average Passenger
Train Count Per Day
❑ Less Than One Per Day
❑ Number Per Day 0
23. Type of Land Use
II Open Space ❑ Farm ❑ Residential ❑ Commercial 0 Industrial ❑ Institutional 0. Recreational 0 RR Yard
24. Is there an Adjacent Crossing with a Separate Number?
❑ Yes IA No If Yes, Provide Crossing Number
' 25. Quiet Zone =(FRA provided)
t
' 3 No _0 24-1-1-••O Partial 0 Chicago Excused: ". Date Established ,
26. HSR Corridor ID
® N/A
27. Latitude in decimal degrees
(WGS84 std: nn.nnnnnnn) 40.7368517
28. Longitude in decimal degrees
(WGS84 std: -nnn.nnnnnnn) -104.7920951
29. Lat/Long Source
Ii Actual ❑ Estimated
30.A. Railroad Use •
31.A. State Use •
30.B. Railroad Use •
31.B. State Use *
30.C. Railroad Use •
31.C. State Use •
30.D. Railroad Use "
31.D. State Use •
32.A. Narrative (Railroad Use) '
32.B. Narrative (State Use)
33. Emergency Notification Telephone No. (posted)
800-848-8715
34. Railroad Contact (Telephone No.)
402-544-3721
35. State Contact (Telephone No.)
303-757-9425
. Part II: Railroad' Information`
1. Estimated Number of Daily Train Movements
1.A. Total Day Thru Trains
(6 AM to 6 PM)
3
1.B. Total Night Thru Trains
(6 PM to 6 AM)
7
1.C. Total Switching Trains
0
1.D. Total Transit Trains
-
0
1.E. Check if Less Than
One Movement Per Day ❑
How many trains per week?
2. Year of Train Count Data (WYY)
2016
3. Speed of Train at Crossing
3.A. Maximum Timetable Speed (mph) 60.
3.B. Typical Speed Range Over Crossing (mph) From 30 to 60
4. Type and Count of Tracks
Main 1 Siding() Yard 0 Transit 0 Industry 0
5. Train Detection (Main Track only)
❑ Constant Warning Time ❑ Motion Detection ❑AFO ❑ PTC ❑ DC [8 Other ❑ None
6. Is Track Signaled?
❑ Yes ® No
7.A. Event Recorder
❑ Yes 51 No
7.B. Remote Health Monitoring
❑ Yes ® No
FORM FRA F 6180.71 (Rev. 3/15)
OMB approval expires 3/31/2018
Page 1 OF 2
EXHIBIT D
U. S. DOT CROSSING INVENTORY FORM
A. Revision Date (MM/DD/YYYY) I
11/21/2017
PAGE 2 I
D. Crossing Inventory Number (7 char.)
804866)
Part III: Highway or Pathway Traffic. Control Device Information
1. Are there
Signs or Signals?
O Yes ® No
2. Types of Passive Traffic Control Devices associated with the Crossing
2.A. Crossbuck
Assemblies (count)
2.8. STOP Signs (R1-1)
(count)
2.C. YIELD Signs (R1-2)
(count)
2.D. Advance Warning Signs (Check all that apply; include count) 13 None
O w10-1 O W10-3 O W10-11
0
0
O W10-2 O W10-4 O W10-12
2.E. Low Ground Clearance Sign,
(W10-5)
O Yes (count 0 )
2.F. Pavement Markings
O Stop Lines ODynamic Envelope
O RR Xing Symbols O None
2.G. Channelization
Devices/Medians
O All Approaches ❑ Median
❑ One Approach' O None
2.1-I. EXEMPT Sign
(R15-3)
O Yes
RI No
2.1. ENS Sign (I-13)
Displayed
O Yes
Ili No
2 No
2.J. Other MUTCD Signs ❑ Yes IA No
Specify Type Count 0
2.K. Private Crossing
Signs (if private)
O Yes O No
2.L. LED Enhanced Signs (List types)
Specify Type Count 0
Specify Type Count
3. -Types of Train Activated Warning Devices at the Grade Crossing (specify count of each device for all that apply)
3.A. Gate Arms
(count)
Roadway 0
3.8. Gate Configuration
O 2 Quad O Full (Barrier)
O 3 Quad Resistance
O 4 Quad ❑ Median Gates
3.C. Cantilevered (or Bridged) Flashing Light
Structures (count)
Over Traffic Lane 0 O Incandescent
3.D. Mast Mounted Flashing Lights
(count of masts) 0
3.E. Total Count of
Flashing Light Pairs
0
O Incandescent O LED
O Back Lights Included O Side Lights
Included
Not Over Traffic Lane 0 O LED
Pedestrian
3.F. Installation Date of Current.
Active Warning Devices: (MM/YYYY)
2 Not Required
3.G. Wayside Horn
O Yes Installed on (MM/YYYY) /
3.H. Highway Traffic Signals Controlling
Crossing
O Yes E No
3.1. Bells
(count)
0
❑ No
3.J. Non -Train Active Warning
O Flagging/Flagman ❑Manually Operated Signals O Watchman O Floodlighting O None
3.K Other Flashing Lights or Warning Devices
Count 0 Specify type
4.A. Does nearby Hwy
Intersection have
Traffic Signals?
❑ Yes O No
4.B. Hwy Traffic Signal
Interconnection
O Not Interconnected
O For Traffic Signals
O For Warning Signs
4.C. Hwy Traffic Signal Preemption
❑ Simultaneous
❑ Advance
5. Highway Traffic Pre -Signals
O Yes 2 No
Storage Distance •
6. Highway Monitoring Devices
(Check all that apply)
O Yes - Photo/Video Recording
O Yes — Vehicle Presence Detection
O None
Stop Line Distance •
Part IV: Physical Characteristics •
1. Traffic Lanes Crossing Railroad O One-way Traffic
❑ Two-way Traffic
Number of Lanes 0 O Divided Traffic
2. Is Roadway/Pathway
Paved?
❑ Yes 2 No
3. Does Track Run Down a Street?
❑ Yes ® No
4. Is Crossing Illuminated? (Street
lights within approx. 50 feet from
nearest rail) ❑ Yes Iii No
5. Crossing Surface (on Main Track, multiple types allowed) Installation Date * (MM/YYYY) / Width • Length •
❑ 1 Timber O 2 Asphalt ❑ 3 Asphalt and Timber O 4 Concrete ❑ 5 Concrete and Rubber O' 6 Rubber O 7 Metal
❑ 8 Unconsolidated O 9 Composite ❑ 10 Other (specify)
6. Intersecting Roadway within 500 feet?
❑ Yes ® No If Yes, Approximate Distance (feet)
7. Smallest Crossing Angle
O 0° - 29° ❑ 30° - 59° ' O 60° - 90°
8. Is Commercial Power Available? •
O Yes ® No
Part V: Public Highway Information
1. Highway System
❑ (01) Interstate Highway System
❑ (02) Other Nat Hwy System (NHS)
❑ (03) Federal AID, Not NHS
❑ (08) Non -Federal Aid
2. Functional Classification of Road at Crossing
O (0) Rural O (1) Urban
O (1) Interstate ❑ (5) Major Collector
O (2) Other Freeways and Expressways
❑ (3) Other Principal Arterial ❑ (6) Minor Collector
O (4) Minor Arterial ❑ (7) Local
3. Is Crossing on State Highway
System?
4. Highway Speed Limit
MPH
O Yes ® No
O Posted ❑ Statutory
5. Linear Referencing System (LRS Route ID) •
6. LRS Milepost •
7. Annual Average Daily Traffic (AADT)
Year 1971 AADT 1
8. Estimated Percent Trucks
%
9. Regularly Used by School Buses?
❑ Yes Lit No Average Number per Day 0
10. Emergency Services Route
❑ Yes O No
. Submission Information ';This information is used for, administrative purposes and is not, available on the public website: ,
Submitted by Organization Phone Date
Public reporting burden for this information collection is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed and completing and reviewing the collection of information. According to the Paperwork Reduction Act of 1995, a federal
agency may not conduct or sponsor, and a person is not required to, nor shall a person be subject to a penalty for failure to comply with, a collection of information unless it
displays a currently valid OMB control number. The valid OMB control number for information collection is 2130-0017. Send comments regarding this burden estimate or any
other aspect of this collection, including for reducing this burden to: Information Collection Officer, Federal Railroad Administration, 1200 New Jersey Ave. SE, MS -25
Washington, DC 20590.
FORM FRA F 6180.71 (Rev. 3/15)
OMB approval expires 3/31/2018
Page 2 OF 2
U. S. DOT CROSSING INVENTORY FORM
DEPARTMENT OF TRANSPORTATION
FEDERAL RAILROAD ADMINISTRATION
EXHIBIT E
OMB No. 2130-0017
Instructions for the initial reporting of the following types of new or previously unreported crossings: For public highway -rail grade crossings, complete the entire inventory
Form. For private highway -rail grade crossings, complete the Header, Parts I and II, and the Submission Information section. For public pathway grade crossings (including
pedestrian station grade crossings), complete the Header, Parts I and ii, and the Submission Information section. For Private pathway grade crossings, complete the Header,
Parts I and II, and the Submission Information section. For grade -separated highway -rail or pathway crossings (including pedestrian station crossings), complete the Header, Part
I, and the Submission Information section. For changes to existing data, complete the Header, Part I Items 1-3, and the Submission Information section, in addition to the
updated data fields. Note: For private crossings only, Part I Item 20 and Part III Item 2.K. are required unless otherwise noted. An asterisk * denotes an optional field.
A. Revision Date
(MM/DD/YYYY)
11 / 16 / 2017
B. Reporting Agency
® Railroad 0 Transit
❑ State 0 Other
C. Reason for Update (Select only one)
RI Change in - 0 New ❑ Closed 0 No Train 0 Quiet
Data ' Crossing Traffic Zone Update
0 Re -Open 0 Date 0 Change in Primary 0 Admin.
Change Only Operating RR - Correction
D. DOT Crossing
Inventory Number
804867R
Part, I::Locationand Classification=Information
1. Primary Operating Railroad ,
Union Pacific Railroad Company [UP]
2. State
COLORADO
3. County
WELD
4. City / Municipality
❑In
5. Street/Road Name & Block Number
CR100 I •
6. Highway Type & No.
13 Near NUNN
(Street/Road Name) I* (Block Number)
NA
7. Do Other Railroads Operate a Separate Track at Crossing? • 0 Yes ® No
If Yes, Specify RR
8. Do Other Railroads Operate Over Your.Track at Crossing? 0 Yes ® No
If Yes, Specify RR .
9. Railroad Division or Region
❑ None DENVER
10. Railroad Subdivision or District
0 None Greeley
11. Branch or Line Name
� None
12. RR Milepost
nnnn.
(prefix). I (nnnn.nnn) I (suffix)
13. Line Segment
•
14. Nearest RR Timetable
Station •
15. Parent RR (if applicable)
NI N/A
16. Crossing Owner (if applicable)
® N/A
17. Crossing Type
IA Public
❑ Private -
18. Crossing Purpose
RI Highway
❑ Pathway, Ped.
0 Station, Ped.
19. Crossing Position
® At Grade
0 RR Under
❑ RR Over
20. Public Access
(if Private Crossing)
0 Yes
0 No
21. Type of Train
RI Freight 0 Transit
0 Intercity Passenger 0 Shared Use Transit
❑ Commuter 0 Tourist/Other
22. Average Passenger
Train Count Per Day
0 Less Than One Per Day
0 Number Per Day 0
23. Type of Land Use
Eil Open Space 0 Farm . 0 Residential ❑ Commercial . ❑ Industrial ❑ Institutional . ❑ Recreational 0 RR Yard .
24. Is there an Adjacent Crossing with a Separate Number?
❑ Yes EA No If Yes, Provide Crossing Number
•;25. Quiet Zone -(FRA provided).,
E No O24'Hr• 0 Partial . ❑:Chicago Excused :.. Date Established:( •
26. HSR Corridor ID
® N/A
27. Latitude in decimal degrees
(WGS84 std: nn.nnnnnnn) 40.7104698
28. Longitude in decimal degrees
(WGS84 std:-nnn.nnnnnnn) -104.7815460
29. Lat/Long Source
® Actual 0 Estimated
30.A. Railroad Use •
31.A. State Use •
30.8. Railroad Use •
31.B. State Use •
30.C. Railroad Use •
31.C. State Use •
30.D. Railroad Use •
31.D. State Use •
32.A. Narrative (Railroad Use) •
32.B. Narrative (State Use) •
33: Emergency Notification Telephone No. (posted)
800-848-8715
34. Railroad Contact (Telephone No.)
402-544-3721
35. State Contact (Telephone No.)
303-757-9425
Part:II Railroad, Information I "
1. Estimated Number of Daily Train Movements
1.A. Total Day Thru Trains
(6 AM to 6 PM)
7
S.B. Total Night Thru Trains
(6 PM to 6 AM)
7
1.C. Total Switching Trains
0 -
1.D. Total Transit Trains
0
I.E. Check if Less Than
One Movement Per Day ❑
How many trains per week?
2. Year of Train Count Data (YYYY)
2016
3. Speed of Train at Crossing
3.A. Maximum Timetable Speed (mph) 60
3.B. Typical Speed Range Over Crossing (mph) From 30 to 60
4. Type and Count of Tracks
Main 1 - Siding0 Yard 0 Transit 0 Industry 0
'5. Train Detection (Main Track only)
❑ Constant Warning Time 0 Motion Detection ❑AFO ❑ PTC 0 DC al Other 0 None
6. Is Track Signaled? -
Iii Yes 0 No
7.A. Event Recorder
0 Yes ® No
7.8. Remote Health Monitoring
0 Yes RI No
FORM FRA F 6180.71 (Rev. 3/15)
OMB approval expires 3/31/2018
Page 1 OF 2
EXHIBIT E
U. S. DOT CROSSING INVENTORY FORM
A. Revision Date (MM/DD/YYYY) I
11 /16/2017
PAGE 2
I D. 804Cr867Rossing Inventory Number (7 char.)
° , Part. Ill: Highway or Pathway Traffic Control.' Device Information •
1. Are there
Signs or Signals?
Yes 0 No
2. Types of Passive Traffic Control Devices associated with the Crossing
2.A. Crossbuck
Assemblies (count)
2.8. STOP Signs (R1-1)
(count)
2.C. YIELD Signs (R1-2)
(count)
2.D. Advance Warning Signs (Check all that apply; include count) 0 None
L W10-1 ❑ W10-3 ❑ W10-11
2
2
❑ W10-2 ❑ W10-4 ❑ W10-12
2.E. Low Ground Clearance Sign
(W10-5)
0 Yes (count 0 )
2.F. Pavement Markings
0 Stop Lines ODynamic Envelope
❑ RR Xing Symbols Ii None
2.G. Channelization
Devices/Medians
0 All Approaches 0 Median
0 One Approach ❑ None
2.H. EXEMPT Sign
(R15-3)
❑ Yes
N No
2.1. ENS Sign (1-13)
Displayed
® Yes
0 No
N No
- 2.J. Other MUTCD Signs ❑ Yes 3 No
Specify Type - Count 0
2.K. Private Crossing
Signs (if private)
❑ Yes ❑ No
2.L. LED Enhanced Signs (List types)
Specify Type Count 0
Specify Type Count
3. Types of Train Activated Warning Devices at the Grade Crossing (specify count of each device for all that apply)
3.A. Gate Arms
(count)
Roadway 0
3.B. Gate Configuration
❑ 2 Quad 0 Full (Barrier)
❑ 3 Quad Resistance
0 4 Quad 0 Median Gates
3.C. Cantilevered (or Bridged) Flashing Light
Structures (count)
Over Traffic Lane 0 ❑ Incandescent
3.D. Mast Mounted Flashing Lights
(count of masts) 0
3.E. Total Count of
Flashing Light Pairs
0
❑ Incandescent 0 LED
❑ Back Lights Included 0 Side Lights
Included
Not Over Traffic Lane 0 0 LED
Pedestrian
3.F. Installation Date of Current
Active Warning Devices: (MM/YYYY) -
____/ N Not Required
3.G. Wayside Horn
Yes Installed on (MM/YYYY) /
3.H. Highway Traffic Signals Controlling
Crossing
❑ Yes13 No
3.1. Bells
(count)
0
❑
3.J. Non -Train Active Warning
❑ Flagging/Flagman ❑Manually Operated Signals ❑ Watchman 0 Floodlighting ❑ None
3.K. Other Flashing Lights or Warning Devices
Count 0 Specify type
4.A. Does nearby Hwy
Intersection have
Traffic Signals?
❑ Yes 0 No
4.8. Hwy Traffic Signal
Interconnection
0 Not Interconnected '
0 For Traffic Signals
0 For Warning Signs
4.C. Hwy Traffic Signal Preemption
0 Simultaneous
0 Advance
5. Highway Traffic Pre -Signals,
❑ Yes 13 No
Storage Distance'
6. Highway Monitoring Devices
(Check all that apply)
❑ Yes - Photo/Video Recording
0 Yes— Vehicle Presence Detection
Cl None
Stop Line Distance * .
PartIVs:Physical Characteristics- :_. ' '•
1. Traffic Lanes Crossing Railroad 0 One-way Traffic
0 Two-way Traffic
Number of Lanes 2 ❑ Divided Traffic
2. Is Roadway/Pathway
Paved?
0 Yes N No
3. Does Track Run Down a Street?
❑ Yes N No
4. Is Crossing Illuminated? (Street
lights within approx. 50 feet from
nearest rail) ❑ Yes N No
5. Crossing Surface (on Main Track, multiple types allowed) Installation Date * (MM/YYYY) / Width • Length'
® 1 Timber ❑ 2 Asphalt ❑ 3 Asphalt and Timber ❑ 4 Concrete 0 5 Concrete and Rubber 0 6 Rubber 0 7 Metal
❑ 8 Unconsolidated 0 9 Composite ❑ 10 Other (specify)
6. Intersecting Roadway within 500 feet?
® Yes ❑ No If Yes, Approximate Distance (feet) 75
7. Smallest Crossing Angle
❑ Cr - 29° ❑ 30° — 59° ® 60° - 90°
8. Is Commercial Power Available? •
N Yes ❑ No
Part V Public -Highway lnformatiolrr
' - I
1. Highway System
• ❑ (01) Interstate Highway System
❑ (02) Other Nat Hwy System (NHS)
❑ (03) Federal AID, Not NHS
RI (08) Non -Federal Aid
2. Functional Classification of Road at Crossing
N (0) Rural 0 (1) Urban
0 (1) Interstate ❑ (5) Major Collector
❑ (2) Other Freeways and Expressways
❑ (3) Other Principal Arterial ® (6) Minor Collector
0 (4) Minor Arterial 0 (7) Local
3. Is Crossing on State Highway
System?
4. Highway Speed Limit
MPH
❑ Yes Q No
0 Posted ❑ Statutory
5. Linear Referencing System (LRS Route ID) '
6. LRS Milepost •
7. Annual Average Daily Traffic (AADT)
Year 1985 AADT 50
8. Estimated Percent Trucks
05 %
9. Regularly Used by School Buses?
❑ Yes _N No Average Number per Day 0
10. Emergency Services Route
❑ Yes ❑ No
Submission- Information This•information,ls used for administrative purposes.and is not available on the publicwebslte , •
Submitted by .. Organization Phone Date
Public reporting burden for this information collection is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed and completing and reviewing the collection of information. According to the Paperwork Reduction Act of 1995, a federal
agency may not conduct or sponsor, and a person is not required to, nor shall a person be subject to a penalty for failure to comply with, a collection of information unless it
displays a currently valid OMB control number. The valid OMB control number for information collection is 2130-0017. Send comments regarding this burden estimate or any
other aspect of this collection, including for reducing this burden to: Information Collection Officer, Federal Railroad Administration, 1200 New Jersey Ave. SE, MS -25
Washington, DC 20590.
FORM FRA F 6180.71 (Rev. 3/15)
OMB approval expires 3/31/2018
Page 2 OF 2
EXHI = IT G
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