Work Zone Mobility and Safety Program

APPENDIX: DATA COLLECTION FORM FOR MANUAL DOCUMENTATION OF QUEUE LENGTHS AND DURATION

Project: _________________________________________________________________________________________
Date Times of Work Activity Times of Work Activity with Lane Closures Queuing During Work Activity with Lane Closures
Time
Begin
Time
End
Dir of
Travel
Loc of
Work
Time
Begin
Time
End
Dir of
Travel
Loc of
Clo-
sure
# Lns
Clsd
Time
Q
Starts
Time
Q
Ends
Q
Lngth
Hr 1
Q
Lngth
Hr 2
Q
Lngth
Hr 3
Q
Lngth
Hr 4
Q
Lngth
Hr 5
Q
Lngth
Hr 6
                                   
                                   
                                   
                                   
                                   
                                   
                                   
                                   
                                   
                                   
                                   
                                   

Notes:
Estimates of queue lengths approximately every hour are desired. However, the time can be adjusted slightly as necessary, as long as the reporting time is noted.
Locations of work and lane closures can be noted using mile markers, stations, etc.

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