Form FRA F 6180.8 FRA F 6180.8 Special Notice for Repair Report

OMB No. 2130-0504
U.S. Department of Transportation
Federal Railroad Administration

Special Notice For Repair Report
Part 1

1. Name of Inspector:

2. ID Number:

6. Operating Railroad:

3. SNFR Report No.:

11. Date:

14. Railroad Official Title:

12. Time:

5. Inspection Rpt. No.:
9. State:

8. City:

7. RR Initials:

10. County:

4. Region:

13. Railroad Official Name:

15. Railroad Division:

16. Railroad Subdivision:

In Accordance With Title 49 CFR Part 216, You Are Hereby Notified Of The Following:
17. Equipment:
[ ] Locomotive
[ ] Freight Car
[ ] Passenger Car

18. Initials & No.:

19. Track No.:

The track described in this report does not comply with Federal Regulations for the class at which it is being operated. The track is
hereby lowered to the class and maximum allowed operating speeds indicated to the left. These speeds shall not be exceeded until the
track conforms to applicable track safety standards for a higher class.

20. Track Class
21. MPH Passenger:
22. MPH Freight:

Is not in serviceable condition and shall be removed from service and remain out of service until it complies with all
applicable Federal Regulations. Movement for repair may only be made in accordance with applicable movement
provisions, conditions, or restrictions, and in accordance with any movement restrictions (if applicable), imposed by
the inspector.

23. Reference Measurement:

25. Location from City, State, and Mile Post:

27a. Line Item No.:

24. Track Description:
26. Location to City, State, and Mile Post:

28a. CFR, Rule, & Subrule:

29a. Defects:

27b. Line Item No.:

28b. CFR, Rule, & Subrule:

29b. Defects:

27c. Line Item No.:

28c. CFR, Rule, & Subrule:

29c. Defects:

27d. Line Item No.:

28d. CFR, Rule, & Subrule:

29d. Defects:

27e. Line Item No.:

28e. CFR, Rule, & Subrule:

29e. Defects:

30. Movement Restrictions: (If Applicable)

When proper repairs have been completed, a detailed report of the repairs must
immediately be sent to the Chief Mechanical Officer (Locomotive or Car), or to the
Chief Engineer (Track), of your company for his/her approval. The form must be sent
to the Regional Administrator whose name and address is given to the right. Use Form
F6180.8A, Special Repair Report Part 2, to report remedial action taken.

31. Regional Administrator Name and Address:

Signature of Inspector

Form FRA F6180.8

9/04

Form FRA F 6180.8 (07/10)

Expires XX/XX/XXXX

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Special Repair Remedial Action Report

OMB No. 2130-0504

Public reporting
burden for this information collection is estimated to average 15 minutes per response,

including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of information. According to the
Paperwork Reduction Act of 1995, a federal agency may not conduct or sponsor, and a person is not
required to respond to a collection of information unless it displays a currently valid OMB control
number. The valid OMB control number for this information collection is 2130-XXXX. All responses to
this collection of information are mandatory. Send comments regarding this burden estimate or any
other aspect of this collection, including suggestions for reducing this burden to: Information Collection
Officer, Federal Railroad Administration, 1200 New Jersey Ave., N.W., Washington D.C. 20590.

Form FRA F 6180.8 (07/10)

Expires XX/XX/XXXX

Page 2 of 2