Proforma C

PRADHAN MANTRI GRAM SADAK YOJANA ( PMGSY-III)

CHECK LIST FOR P.I.U. & S.T.A.
( For Indvidual Road Works )
To be filled by PIU.

1. Location :- State: Odisha District : Sundargarh Block Balisankara

2. Package No:- OR-30-674

3. Name of the Road: From Khamarimunda To to Halma via Kinjrikela Sikajore

4. Total Length (Km) - 14.00 In Built up area - 0 Km In Open Area - 14.00 Km

5. Type of proposal : Upgradation/Riding Quality Improvement/Both:-Both

If portion of the proposed road is existing PMGSY road than indiacte

1-PWD road to Sikajore L55,
Name of the road : 2-Khamarimunda to Kinjirikela L/T No. L45,
3-Khamarimunda to Kinjirikela L45

2006-2007, 31-03-2015, 1-18

Year of sanction under PMGSY 2008-2009 Year of completion 16-05-2014 Design Traffic ( ESAL) 2-143286
2008-2009 19-04-2014 3-143286

Yes NO
Whether road deteriorated due non maintenance

6. Estimated Cost Rs :
Normal Area
Cost sharing pattern for this road Special Area (90:10)
(60:40)

Total Cost in Average Cost per Km.

Item
Rs. Lakhs
Flexible Pavement 619.86 44.28
Rigid Pavement 0.00 0.00

Others ( CD Works, Protective works & Misc items) 318.61 22.76

Cost due to higher specification such as carriage way width, Higher Axle
8.25 0.59
load , Hard shoulders, Shifting of Utilities

GST & LWF 113.61 8.11

Total Project Cost 1060.32 75.74
MoRD Share 636.19
State Share 424.13

7. Is the road a part of DRRP and Approved CUCPL Yes/No

DRRP
Component
Road Road Name Trace Map Rank
Road 1
Number

Component RR(VR)L1
Sikajorre to Halma (1406501) 50
Road 2 13
a) If yes, what are the Trace map rankings of the components of the
cnadidate road?
Component RR(VR)
Khamarmunda to Sikajore Via Kinjirikela (1508898) 2
Road 3 MRL-01

Component
Road 4

b) If Yes , Through Route/ MRL No. T- RR(VRT)T-03 OR MRL-

Name of Habitation Population Overall Weightage

Halma 695
c) Names of benefitted habitations
Khamarimunda 429
Kinjirikela 2268
Sikajore 1053
Katijore 607
Kupatangar 1119
Orampara 232
Deobhubanpur 4460
Gurdihi 291
Oriyapada 254
Total weight

d) Utility value = Total weight/ Length of road 9.23

e) Name of facilities located on this proposed road as per DRRP:

f)Whether the proposed road leads to

MDR SH NH

g) Average PCI of the road to which proposed TR or MRL will be connected 5.00

h) Average PCI value of proposed road 3&2

i) If PCI of MDR / SH / NH is 3 or below , whether the State's undertaking for simultaneouly upgrading Yes No
it from State fund is avaible

j) Age of the proposed road 10 years

k) Existing surface of proposed road BT & Earthen

l) Cummalative maintenance expenditure in last three years( in lacs)
m) Whether the road proposed using new technologies Yes No
If Yes, Name of the technology proposed West Plastic
carriage way Roadway width Road land width
8. a) Whether the Proposed Road has the desired carriage way
width,Roadway width and Road Land Width (RLW ) yes No yes No yes No

b) Indicate the actual widths of the following for the proposed road In the Built Up Area (m) In the Open Area (m)

i) Carriageway 3.75 3.75

ii) Roadway 7.50 7.50
iii) Road Land Width 10 to12 15 to 15

c) Indicate the proposed widths of the following for the proposed road In the Built Up Area (m) In the Open Area (m)

i) Carriageway 5.50 5.50

ii) Roadway 9 9.00

INDEX MAP (not to scale ) : Attached saperately

Enroute Habitations Name / Chainage

5/440 5/630 8/040 8/320 8/500 8/850 11/350 12/590 12/670

MDR-42
MSH-6
ROAD

H- Habitation

F-Facilities name

CD1 CD2 CD3 CD4 CD5 CD6 CD7 CD8 CD9

Link-1
9 Name of Road :
Cross Section details
Exising BT Surface 3.75 Mtr Item Thickness
OGPC 25
WBM Gr-III 75
WBM Gr-II 75
GSB 150

b) Cross Section of The Proposed road showing different component layers.

(Should be as per Actual Provisions of DPR) Item Thickness
TCS of New Construction OGPC 20
WBM Gr-III 75
WBM Gr-II 75
GSB 175

WBM GR-IiI-75 mm

WBM GR-II-75 mm
GSB-175 mm
Item Thickness
OGPC 20
WBM Gr-III 75
WBM Gr-II 75
GSB 175

WBM GR-IiI-75 mm

WBM GR-II-75 mm
GSB-175 mm
 10 Base year traffic volume
Month & Year of Traffic Volume Count =
Motorised Traffic Non Motorised Traffic

Cars,Jeep, Motorised Light

Trucks Agricultural Tractors Trallers Buses Animal Drawn Vechicle
Cycle
Days Vans,Three two Commercial Cycles
L U OL L U OL L U OL Rickshawa SWC Num. Tyred
Wheelers Wheelers Vehicle

Day 1 1177 984 33 17 18 0 27 22 0 0 0 0 121 0 4 0

Day 2 768 1191 49 12 8 0 23 36 0 0 0 0 156 2 6 0
Day 3 805 1080 66 18 11 0 28 29 0 3 0 0 123 2 10 0
Average 916.67 1085.00 49.33 15.7 12.3 0.00 26.00 29.00 0.00 1.00 0.00 0.00 133.33 1.33 6.67 0.00

3 days traffic cound is required in case design is done using IRC SP:72-2015 and 7 day count required in case design is done with IRC 37:2018
Passenger car unit( PCU) 1919
a Traffic Details in case degisn is done as per SP IRC 72:2015
ADT in the year of Traffic Count = 2280

Growth rate adopted (%) = 6% Base Year Traffic AADT (T) = 2542
Design Life = 10 Years
Number of Harvesting Seasons = 2

No. of Days in Each Harvesting Season (t) = 70

Value of (n) assumed = Cumulative ESAL = 413024

Traffic Category = T 6
b Traffic Details in case degisn is done as per IRC 37-2001 /IRC 37 :2012

A= Intitial traffic in the year of completion of construction in terms of the number of commericial vehicles per day 160.06
D= Lane distribution factor 0.75
F= Vehicle damage factor 3.9
n= Design life in years 10
r= growth rate adopted % 0.06
N= The cumulative number of standard axles to be catered for the design in terms of msa .=say 5 msa

CVPD 151.00
11. Subgrade CBR ( for Different Sections ) =
Chainage 0/000-1/000 1/000-2/000 2/0-3/000 3/0-4/0 4/0-5/0 5/0-6/0 6/0-7/0 7/0-8/0
Design
CBR %
5.90 6.10 5.70 5.49 6.15 6.12 5.89 6.16

Chainage 8/0-9/0 9/0-10/0 10/0-11/0 11/0-12/0 12/00-13/00

Design
CBR %
6.11 6.18 5.79 6.20 6.14

12. Cost Details of upgradation proposal

A. Pavement Components

Cost/ km
Description of layer Thickness in mm Quantity Rate Rs Cost Rs.
(Rs)

Clearing, scarifying, dismantling existing CDs etc variable 426272.73 30448.052

Earth Work - in Excavation/ Cutting variable 2098676.23 149905.45
Earthwork- in Filling (Embankment) variable 4095084.16 292506.01
Subgrade (if provided seperately)/ Treated subgrade
Shoulders (If not considered in the Earthwork)
Granular Sub base 0.20 8882.62 2251.00 19994766.37 1428197.6

Soil + Aggregate Mix 0.100 5250.00 171.15 898540.76 64181.483

WBM Gr -I I 0.075 1450.73 2900.01 4207117.01 300508.36

WBM Gr -I I I 0.075 1450.73 2958.94 14316086.13 1022577.6

WMM 0.15 0.00 2489.71 0.00 0

Bituminous Layers

Prime Coat 34273.25 35.76 1225611.42 87543.673

Tack Coat 79310.00 12.05 955685.50 68263.25

BM /DBM ( if designed using IRC 37-2018, DBM is applicable) 0.05 0.00 5747.85 0.00 0

OGPC /SDBC/BC ( SDBC / BC if designed using IRC 37-2018) 0.025 79310.00 128.83 10217829.01 729844.93

Seal Coat 79310.00 44.76 3549915.60 253565.4

Surface Dressing
Total cost of Flexible pavement 61985584.92 4427541.8
Cement Concrete Road

IRCSP 62:2014 IRC 58-2011

Design done with

GSB

WBM/WMM

Dry lean concrete( DLC)

Concrete for Pavement (M30)
Total Cost of Concrete Pavement
B: C D Works
Location - Chainage ( Similar Type of CD's may be
Type of CD & their Nos Total Length of Culvert Cost in Rs.( in lacs)
grouped together)
i Existing CD ( requiring repair)

New proposed CD ( including complete replacement of

ii
existing CDs)
1000mm dia Single Row 5.00 1113520.34
1000mm dia Double Row 0.00 0.00
1000mm dia Three Row 0.00 0.00
RCC BOX CELL CULVERTS 1.00 4 Mtr (2x2x2) 1139721.15
16773753.99

Total Cost of CD works in lacs 167.74

C. Protection works
Chainage
Average cost /
From To Length( m) Cost in Rs
m
Retaining wall 8/450 & 4/160 1000 6679620.60 477115.76
Breast wall 0
Toe wall 8/610 to 8/850 785 5096771.60 364055.11
Gabbion
Pitching / turfing for slopes
Total cost of protection works 11776392.20 841170.87

D. Pucca Side Drains (if Provided) Chainage Cost in Rs Average cost / m

Length(
From To m)

Ch-8/610 to 8/850 558088.20 39863.44

300
Ch-8/040 to 8/100

Total cost of side drains works 558088.20 39863.44286

E. Road Logo, other Road Furniture including Road safety signs
Number Cost in Rs Average cost / km
Number of Boards 2472520.55 176608.61

Total cost of road furniture

F. Any other Provisions (Please Specify) 1105000.00 78928.57

Total Cost of the Project (Rs) 94671339.86 6762238.561

13. Five Year Routine Maintenance
To be estimated as per provision of Operation Year Cost in lakhs % Cost Cost /km
Manual I 10.82 1.14 0.77
II 12.98 1.37 0.93
III 15.15 1.60 1.08
IV 17.31 1.83 1.24
V 19.48 2.06 1.39

Renewal coat after 5 years 210.00 22.18 15.00

Total Maintenance Cost 285.74 30.18 20.41

Maintenance after 6th years renewal coat

I 23.37 2.47 1.67

II 27.27 2.88 1.95

III 31.16 3.29 2.23

IV 35.06 3.70 2.50

V 38.95 4.11 2.78

Total Maintenance Cost 155.80 16.46 11.13

Grand Total of maintenance 441.54 46.64 31.54

Yes NO

14. Whether the road has Geometrics as per Rural Roads Manual RRM / Latest Circulars of NRIDA.

Yes No

15.Whether C.D.works / Protection works are provided as per RRM / Latest Circulars of NRIDA/ Respective Codes of IRC.

Vetted at NRIDA
Year
16.Does the Estimation Conform to Standard Rate Analysis and SSR generated for the current Phase
Yes No
17. Sources and the Lead distances of Materials are as under
Lead
Material Source Distance Material Source Lead Distance
(Km)
Earth Cement Rajgangpur 130
Murrum Local 7 Emulsion HALADIA 620
(Subgrade)
Aggregate Gotidhara 130 Bitumen HALADIA 620
Sand Ichha River 19 Steel Rourkela 129
M-Sand Ichha River 19

NOTE -: Certified that this road is connecting to Block Head quarter ,main link roads,important direct indirect habitation , therfore more than T4 traffic is proposed.

Certified that information provided is true

Prepared By
Technical Scrutiny at STA
(Name) Checked By
done by:
Counter Signatures of
Co-ordinator STA :
 To be filled by State Technical Agency
Name of the STA: Rourkela

Name of Road : Khamarimunda TO to Halma via Kinjrikela Sikajore Yes / NO to be filled by STA in own handwriting

Is the Proposed Road entered on the OMMAS under PMGSY III proposal module:
18
(Data entries to be verified by STA before Clicking the Propopsal)

a. Have you satisfied yourself that the proposed road is a part of DRRP Yes
19
Are you satisfied that the proposed road is significantly more beneficial to the public than the roads with higher
b.
trace maps rank in the same block?

Are you satisfied with the following

a. Engineering Surveys (L section, X section on A3 size paper must be verified) Yes / No

b. Soil/ Material Investigation ( CBR, Density, LL, PI, Gradation to be verified) Yes / No
20

c. Whether Traffic Surveys / count has been done by third party Yes / No

Hydraulic Studies.
d. Yes / No
( Catchment for structures with more than 2 Vents to be verified from topo sheet. Location and requirement of all
CD structures to be verified from L section )

In case , Traffic is projected beyond T 7 Category and road designed using IRC 37 are you satisfied with the
a. Yes / No
reason given by PIU
21
Whether 3rd party Traffic verification / Axle load Surveys carried out on such roads designed with more than 1
b. Yes (Axle Load Survey data Not Enclosed)
MSA traffic and carriageway width of 5.5 m

a. In case, sub grade CBR is less than 5; has Soil Stabilisation etc. been proposed NA
22

b. ( If not , specific Reasons given by PIU)

Is the design of the following elements as per Rural Roads Manul / Circulars of NRIDA:

a. Alignment & Geometrics Yes / No

23 b. Location and type of CD works and Side drains Yes / No

c. Integration for Cross and longitudinal Drainage Yes / No

d. Protection Works Yes / No

Is the design of flexible Pavement as per IRC SP: 72- 2015 and design of Rigid Pavement as per IRC SP:62-
a. Yes / No
2014 .
24
b. Is the design of flexible Pavement as per IRC 37 2018 and design of Rigid Pavement as per IRC SP:58- 2011. NA

Does the proposal have provisions for

a. PMGSY Logo Sign Boards and Information Board Yes / No

25 b. Km/Hm Stones Yes / No

c. Guard Stones (where necessary ) Yes / No

d. Traffic Sign Boards (as necessary) Yes / No

a. Are you satisfied with the Road safety provisions made in the DPR Yes / No
26
b. Whether Road Safety Audit certificate attached in case of the proposed length is more than 5 Km Yes / No

Secific Remarks, if any, by STA

( Specific remarks of STA about the overall project are necessary on each DPR)

27

Certified that the Design and Estimation for the Proposed Road work are based on the data and SSR provided by PIU Engineers . The Proposal after final Correction is entered on the
OMMAS.The Propasal may be considered for clearance.

Technical Scrutiny at STA done by: Co-ordinator STA:

Signature Signature
Name Name
Date Date