Form URCI

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Hari Inspeksi : Senin Panjang : 1.

000 Meter
Tanggal Inspeksi : 02.02.2022 Lebar : 25 Meter
Nama Jalan : Haul Road SST Jam : 09.00
Kategori Jalan : Jalan Utama Inspektor : Heru
Sisi Drainase : 2 Kanan dan Kiri Jalan
Jenis Kerusakan
D1 Potongan melintang jalan D4 Jenis Kerusakan D7 Agregate Lepas
D2 Drainase D5 Jalan Berlubang
D3 Jalan bergelombang D6 Lendutan ( Ruting )
Kategori Jalan
M1 Jalan Utama M3 Akses Disposal M2 Akses Front
Sketsa

Jenis Kerusakan Level Ukuran


No. Panjang Lebar Luas Area
D1 D2 D3 D4 D5 D6 D7 Low Medium Hight
(m) (m) (m2)
1 √ √ 250 10 2500

2 √ √ 300 20 6000

3 √ √ 80 5 400

4 √ √ 40 8 320

5 √ √ 80 5 400

6 √ √ 40 8 320

7 √ √ 0

8 √ √ 2 4 8

9 √ √ 10 4 40

10 √ √ 400 4 1600

11 √ √ 300 10 3000

12 √ √ 200 5 1000

13 √ √ 500 5 2500
Jenis Kerusakan Severity Level Area Kerusakan Total Area Segment (m2)

ImProper Cross-section Low 250 x 10 = 2500


Bentuk CrasFall Medium 300 x 20 = 6000 1000 x 25 = 25000
D1 Hight
Inadeguate RoadSide Drainage Low 80 x 5 = 400
drainase pinggir jalan yg tidak memadai Medium 40 x 8 = 320 1000 x 25 = 25000
D2 Hight
Corrugation Low 80 x 5 = 400
Kontruksi Medium 40 x 8 = 320 1000 x 25 = 25000
D3 Hight
Dust Low
Debu Medium 1000 x 25 = 25000
D4 Hight
Potholes Low 20 x 40 = 800
Lubang Kecil Medium 10 x 50 = 500 1000 x 25 = 25000
D5 Hight
Ruts Low 400 x 4 = 1600
Bekas Roda Medium 300 x 10 = 3000 1000 x 25 = 25000
D6 Hight
loose Agregat Low 200 x 5 = 1000
Kehilangan Agregat Medium 500 x 5 = 2500 1000 x 25 = 25000
D7 Hight
Area Segment (m2) Density

2500 : 25000 10%


00 x 25 = 25000 300 : 25000 1.20%

400 : 25000 1.60%


00 x 25 = 25000 320 : 25000 1.28%

400 : 25000 1.60%


00 x 25 = 25000 320 : 25000 1.28%

00 x 25 = 25000

800 : 25000 3.20%


00 x 25 = 25000 500 : 25000 2%

1600 : 25000 6%
00 x 25 = 25000 3000 : 25000 12%

1000 : 25000 4%
00 x 25 = 25000 2500 : 25000 10%
L 0.8
M 0.7

L
M

L
M
1.60%
1.28%

1
1
nilai
L 5%
M 0.6%

L 10%
M 1.20%

L 9
M 2
L 0.80%
M 0.70%

L 1.60%
M 1.28%

L 2
M 2
L 3%
M 6%

L 6%
M 12%

L 9
M 19
L 0.01%
M 0.06%
L 3.20%
M 2%

L 7
M 6
L 4%
M 10%

L 3
M 9
Jenis Kerusakan Severity Level Deduct Value

ImProper Cross-section Low 9


Bentuk CrasFall Medium 2
D1 Hight
Inadeguate RoadSide Drainage Low 1
drainase pinggir jalan yg tidak memadai Medium 1
D2 Hight
Corrugation Low 2
Kontruksi Medium 2
D3 Hight
Dust Low
Debu Medium
D4 Hight
Potholes Low 7
Lubang Kecil Medium 6
D5 Hight
Ruts Low 9
Bekas Roda Medium 19
D6 Hight
loose Agregat Low 3
Kehilangan Agregat Medium 9
D7 Hight
Deduct Value
Jenis Kerusakan Severity Level Deduct Value

ImProper Cross-section Low 9


Bentuk CrasFall Medium 2
D1 Hight 0
Inadeguate RoadSide Drainage Low 1
drainase pinggir jalan yg tidak memadai Medium 1
D2 Hight 0
Corrugation Low 2
Kontruksi Medium 2
D3 Hight 0
Dust Low
Debu Medium
D4 Hight
Potholes Low 7
Lubang Kecil Medium 6
D5 Hight 0
Ruts Low 9
Bekas Roda Medium 19
D6 Hight 0
loose Agregat Low 3
Kehilangan Agregat Medium 9
D7 Hight 0
TOTAL DEDUCT VALUE ( TDV )
q<5
Deduct Value Corrected Deduct Value

9+2+0 11

1+1+0 2

2+2+0 4

7+6+0 13

9 + 19 + 0 28

3+9+0 12

70
2
70
2

45

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