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?
Record the height of any 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