FRA F 6180.175 Blocked Crossing Reporting Form

FEDERAL RAILROAD ADMINSTRATION

OMB Approval No.: 2130-0630

Public reporting burden for this information collection is estimated to average 3 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 2130-0630. All responses to this collection of information are voluntary. Send comments regarding
this burden estimate or any other aspect of this collection, including suggestions for reducing this burden to: Information
Collection Officer, Office of Safety, Federal Railroad Administration, 1200 New Jersey Ave., S.E., Washington D.C. 20590.

BLOCKED CROSSING REPORTING FORM
Use this form to report a blocked crossing. Please report only once for each blocked crossing.
There are no federal laws or regulations pertaining to blocked crossings. Therefore, this information is only
being used to track the location and impacts of blocked crossings. FRA's purpose of collecting this
information is to learn where, when, for how long, and what impacts result from blocked highway-rail
grade crossings. FRA may share this information with stakeholders, including railroads, state and local
governments, and other federal authorities. There may be legitimate operating and/or safety-related
reasons for a crossing to be occupied by a slow or idling train.
1. Where was the crossing?
City
State
Street
Nearest Cross Street (optional)
DOT Crossing Number. This information can be found on the blue Emergency Notification System
Sign posted at the crossing. (optional, if known)
Railroad Name (optional, if known)
2. Have you contacted the railroad?

Yes or

No.

3. What was the reason the crossing was blocked? (check one)
A stationary train
A slow-moving train
No train was present but the lights and/or gates were activated
4. When did you observe that the crossing was blocked?
Date
Time

:

AM/PM

FRA F 6180.175 (1/22)

Expires: 11/30/2022

5. If you witnessed the train stop and start, how long was the duration that the crossing was blocked?
hours:

minutes OR From:

AM/PM To:

AM/PM

OR

NA

6. For this event, were you aware of any immediate impacts from the crossing blocked? (Check all that
apply):
First responders were observed being unable to cross the tracks
Pedestrians were observed climbing on, over, or through the train cars
Other

7. Any additional comments about this event? (i.e. school arrival/dismissal disrupted; postal or other deliveries
delayed; fewer customers visiting businesses, traffic congestion/gridlock, etc.)

FRA F 6180.175 (1/22)

Expires: 11/30/2022