Curb Ramp Inspection Form 
                                                                                 Must be filled out for every ramp constructed in County      
                                                                                 right-of-way in Sacramento County. This from must be filled  
                                                                                 out and submitted within ten days of ramp construction to  
                                                                                 the SacDOT Program Access Coordinator. 
 

          Curb Ramp Location:             Project Name:__________________________ 
 
      . N/E     . N/W    . S/E     . S/W 
 

N/S STREET_______________________________               E/W STREET______________________________

 

    Curb Ramps per County Standard Drawing 4-23 & 4-24:  Check One: 
  . Vertical Curb . Rolled curb     . One Ramp     . Two Ramps 
 
STANDARDS: 
 
-  NO POLES OR PULLBOXES SHALL BE LOCATED IN RAMPS 
- ALL ELEMENTS, EXCEPT GUTTERS AND RETAINING CURBS, 
     MUST BE CONSTRUCTED PLANAR IN NATURE, WITH WEAKENED 
     PLANED JOINTS SCORED BETWEEN EACH ELEMENT. 
- PAN  MUST BE WITHIN STRIPED CROSSWALKS 
 


A1:_______    B1: _______    C1: _______    D1: _______                    
A2:_______    B2: _______    C2: _______    D2: _______ 
A3:_______    B3: _______    C3: _______    D3: _______ 
RIGHT SIDE LENGTH:  ________ FT. _________ IN. 
PAN WIDTH:                  ________ FT. _________ IN. 
LEFT SIDE LENGTH:    ________ FT. _________ IN. 
 
IF TWO RAMPS ON CORNER (DATA FOR 2ND RAMP): 
 
E1:_______    F1: _______    G1: _______    H1: _______ 
E2:_______    F2: _______    G2: _______    H2: _______ 
E3:_______    F3: _______    G3: _______    H3: _______ 
RIGHT SIDE LENGTH:  ________ FT. _________ IN. 
PAN  WIDTH:                 ________ FT. _________ IN. 
LEFT SIDE LENGTH:    ________ FT. _________ IN. 
DISTANCE BETW. RAMPS: ______ FT. _______ IN. 
      STREET NAME: ________________________ 
 
        Inspected/measured by (print):______________________  Date Field Measured:__________________ 
 

 
Directions: 
Three measurements for all data shall be taken at the ramps and pans, one measurement shall be taken at the centerline of the element and the other two shall be taken 18 inches on either side of the first measurement for the element. None of the three recorded measurements of any element may exceed the limits indicated above.  
See reverse side for Compliance with Standards. 
                                        Page 1 
Curb Ramp Inspection Form 
 
                     Compliance with Standards: 
 
 
Note:  All curb ramps should comply with SacDOT’s current design and construction standards. Where it is infeasible to construct or reconstruct a curb ramp to current standards, the Designer or Inspector must complete the Findings for Non-compliance Element(s) section below and state what the non-compliant element(s) are and the reason for the non-compliance. A drawing or picture can be included in the box below. After completing this form submit it to the SacDOT Program Access Coordinator for acceptance and then signature by the Director of SacDOT. 
 
Findings for Non-Compliance Element(s):  ___________________________________________________ 
___________________________________________________________________________________ 
___________________________________________________________________________________ 
___________________________________________________________________________________ 
___________________________________________________________________________________ 
___________________________________________________________________________________ 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
          Picture or Drawing, if needed 
 
           ______________________   _______________________   _______________________   __________________________ 


  Designer/Inspector   Date  Reviewed by             Date  Approved by SacDOT          Approved by Chief, Disability 
                                             Program Access Coord.      Director                     Date    Compliance, Sac. Co.      Date 
 
___________________   __________________   ___________________   ______________________ 
Designer/Inspector Signature  Reviewed by Signature  SacDOT Dir. Signature       Chief Disability Comp. Signature 
                                                                                                    Page 2