Engineering Assessment Form

Project Name*

Project Location*

Project Timeframe (Optional)

Engineer of Record (Optional)

Contact Information*

Optional, but helpful!
Please email the following items to FyfeEngineering@cs-nri.com
1. Dimensioned sketch or drawings2. Dimensioned section of each element3. Inspection reports, if available

Brief Explanation of Project*

Existing Conditions (Optional)

Elements to be strengthened

Section dimensions

Concrete and steel material properties

Steel reinforcing details

Existing capacity

Existing loads

Occupancy & Access:

Clearly Stated Design Goals (Optional)

Exposure Conditions & Finish Requirements (Optional)

Would you like to set up a lunch and learn seminar on FRP? (Optional)

YesNo

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Project Name
Project Location

Project Owner

When possible please email the following items to FyfeEngineering@cs-nri.com
Plan and profiles drawingsPipe section shop details/lay schedulesInspection reportsNumber of sections to be repairedTotal length to be repaired

Pipeline Information

Pipeline ID, Internal Diameter(s)

Pipeline Material(s)

PCCP (Pre-stressed Concrete Pipe)Metallic (steel, cast Iron, ductile iron)RCP (Reinforced Concrete Pipe)Bar wrapped pipe (C-303)Other

Installation Use/Design Requirements: Please provide values and applicable units of measure

1. Operating pressure:

2. Total pressure (operating + surge):

3. Vacuum pressure:

4. Depth of cover:

5. Soil modulus of reaction:

If unknown okay to assume?

YesNo

6. Soil Density:

7. Water table height above top of pipe:

8. Temperature Fluctuation (Min./Max.):

9. Live Loading (e.g., HS-20):

10. Thrust Load:

Conveyance/Distribution Use:

Select all that apply

Potable WaterSanity SewerRaw WaterStormCirculation WaterPenstockOther

Please describe condition issues:

Please describe renewal goals (e.g., full structural, partial structural, local repairs, etc.):

Critica Infrastructure needs the contact information you provide to us to contact you about our products and services. By submitting the form you accept our policy terms. You may unsubscribe from these communications at any time. For information on how to unsubscribe, as well as our privacy practices and commitment to protecting your privacy, please review our Privacy Policy.