Aesthetic Treatment Submittal Form

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Contact Information
Agency Name: ^*
Agency Contact Person: ^*	Phone Number: ^*
Secondary Contact Department Head: ^*	Phone Number: ^*

About the Project
Project Name: ^*
Beginning Construction Date: ^*	Ending Construction Date: ^*
Location*	Size* (Please specify the units of measurement used)
State:	Area:
County:	Length:
Country:	Height:
Distance to nearest town (population greater than 50,000):

Type of Bid
Separate Bid Item: Contract Bid Quantity: Final Unit Price: Incidental to another Bid: Estimated Additional Cost:

Cost:
^* $ ^*

Photographs and Detail Illustrations:
Include color photograph(s) of the project and treatment: * (.jpg or .zip accepted, if you have more than one image please zip them) If available, please include a typical cross section or detail from the project plans as well as construction specifications. (.zip, .doc, .pdf accepted) Please describe any sorts of awards received by this project. Include any URL links or PDF files if possible:

Treatment Type*
1-Retaining Walls Form Liner Treatments Painted or Stained Face Natural Stone Facing Vegetation Planted Facing Shotcrete Facing MSE with Precast Facings Modular Block Walls Welded Wire Faced Timber Faced Simulated Stone Facing Custom Treatments Bush Hammer Finished Concrete 2-Bridges Colored or Stained Concrete Stone Masonry or Simulated Stone Form Liner Treatments Custom Treatments Steel Timber 3-Barriers Special Steel Guardrail Treatments Steel Backed Timber Stone Masonry or Simulated Stone Concrete Core with Stone or Timber Facade Gabion Barriers Concrete Vehicle Barrier with Aesthetic Treatment Railings on Structures (Vehicular/Pedestrian) Special Steel Barriers 4-Fences Rockfall Protection Fence Colored Vinyl Coated Chain Link or Gabion Mesh Fences or Slope Screening	5-Bioengineering Treatments Waddles Bio-Logs Live Stakes Live Planted Walls Logs and Boulders on Slope Bounded Fiber Matrix Organic Based Fertilizer Riprap Barbs Matting 6-Rock Cut Slopes Rock Staining Rock Sculpting Half Casts Bush Hammer 7-Soil Cut Slopes Serrated Soil Creation of Natural Looking Land Forms Special Vegetative Treatments Reinforced Slopes Special Erosion Control Treatments 8-Fill Slopes Steep Rock Fills Special Vegetated Treatments Reinforced Slopes Special Erosion Control Treatments 9-Landslide Mitigation 10-Pavements Projects Design Other

Reason(s) the Aesthetic Treatment Was Used^* Explain why this treatment was selected and used...

Additional Comments:

Thank You!

U.S. Department of Transportation

Federal Highway Administration

Aesthetic Treatment Submittal Form

Contact Information

About the Project

Treatment Type*

Thank You!