Railroad Crossing Permit and Flagging Coordination

Coordination form for any bore, excavation, or aerial crossing of railroad right-of-way, capturing application status, flagging requirements, and on-track safety briefing details.

Project and Submission Details

• Project Name
• Submission Date
• Requestor Name
• Requestor Email
• Requestor Phone
• Company or Utility Name

Crossing Scope

• Type of Railroad Crossing
• Railroad Company / Owner
• Crossing Location
  Enter the nearest street, milepost, station, crossing ID, or landmark.
• Description of Work Within Railroad ROW
• Planned Work Start Date
• Planned Work End Date

Permit Application Status

• Permit Application Status
• Permit Number
• Permit Submission Date
• Permit Conditions or Restrictions
  Summarize any railroad conditions, time restrictions, restoration requirements, or access limitations.
• Approval Document

Flagging and On-Track Safety

• Is Railroad Flagging Required?
• Date Flagging Was Requested
• Estimated Flagging Hours
  Enter the estimated number of hours of railroad flagging support needed.
• Is an On-Track Safety Briefing Required?
• Safety Briefing Date
• Briefing Attendees
  List the people who attended the on-track safety briefing.

Work Controls and Acknowledgment

• Planned Work Controls
• Emergency Contact Name
• Emergency Contact Phone
• Acknowledgment