FRA F 6180.96a Inspection Report (Continuation sheet)

INSPECTION REPORT

DEPARTMENT OF TRANSPORTATION
FEDERAL RAILROAD ADMINISTRATION (FRA)

Inspector's ID No.

(Continuation)

Report No.
yy

Date
mm

dd

OMB No. 2130-0509
Item

Initials/Milepost

Equipment/Track #

Type/Kind

49 CFR/USC

Defect Code

Subrule

Speed

Class

Train #/Site

SNFR *

RCL ** # of Occ. ***

Activity Code

Description

Violation Recommended

Yes

No

Written Notification to
FRA of Remedial Action is:

Required

Optional

Item

Initials/Milepost

Equipment/Track #

Type/Kind

Latitude:
Railroad
Action Code

49 CFR/USC

Defect Code

Subrule

Longitude:
Date (mm/dd/yyyy)
Speed

Class

Train #/Site

____/____/____
SNFR *

Comments on back?

RCL ** # of Occ. ***

Activity Code

Description

Violation Recommended

Yes

No

Written Notification to
FRA of Remedial Action is:

Required

Optional

Item

Initials/Milepost

Equipment/Track #

Type/Kind

Latitude:
Railroad
Action Code

49 CFR/USC

Defect Code

Subrule

Longitude:
Date (mm/dd/yyyy)
Speed

Class

Train #/Site

____/____/____
SNFR *

Comments on back?

RCL ** # of Occ. ***

Activity Code

Description

Violation Recommended

Yes

No

Written Notification to
FRA of Remedial Action is:

Required

Optional

Item

Initials/Milepost

Equipment/Track #

Type/Kind

Latitude:
Railroad
Action Code

49 CFR/USC

Defect Code

Subrule

Longitude:
Date (mm/dd/yyyy)
Speed

Class

Train #/Site

____/____/____
SNFR *

Comments on back?

RCL ** # of Occ. ***

Activity Code

Description

Violation Recommended

Yes

No

Written Notification to
FRA of Remedial Action is:

Required

Optional

Latitude:
Railroad
Action Code

Longitude:
Date (mm/dd/yyyy)

____/____/____

Comments on back?

Public reporting burden for this information collection is estimated to average 15 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 respond 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 this information collection is 2130-0509. All responses to this
collection of information are mandatory. Send comments regarding this burden estimate or any other aspect of this collection, including suggestions for reducing this burden
to: Information Collection Officer, Federal Railroad Administration, 1200 New Jersey Avenue, SE, Washington, D.C. 20590.
* SNFR - Special Notice for Repairs

Form FRA F 6180.96a (Revised 10/02)

FRA COPY

OMB approval expires 01/31/2019

** RCL - Remote Control Locomotive

*** # of Occ. - Number of Occurrences

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