Action Traffic Control Site Condition & Safety Audit

• Audit Title

• Document No.

• Conducted on

  Date

Auditor Details

• Auditor Name:

• Qualification:

  Level 1 STMS

  Level 2/3 NP STMS

  Level 2/3 P STMS

• Transit Number:

• Signature:

  Sign

STMS Details

• STMS Name:

• Qualification:

  Level 1 STMS

  Level 2/3 NP STMS

  Level 2/3 P STMS

• Transit Number:

• Signature:

  Sign

Site Details

• Location:

• Contractor / Client:

• Site Activity / Work:

• TMP Sighted:

• CAR / TMP Number:

• Level of TTM:

  Select LV L1 L1/2 L2 L2/3 L3

  • LV
  • L1
  • L1/2
  • L2
  • L2/3
  • L3

• RCA:

Induction

• Provided an Adequate Induction

• Number of Occurrences:

• Comments

TMP / Qualified in Charge

• TMP Not Approved / Not On Attended Site

• NON-CONFORMANCE Unless Produced Within 30 Minutes Add Comments

• No Qualified Person On Attended Site

• NON-CONFORMANCE Add Comments

Signs

• Missing Signs(including side roads and sub-plates)

• Number of Occurrences:

• Comments

• Photo

  Media

• Missing Delineation Device

• Number of Occurrences:

• Comments

• Photo

  Media

• Spacing (too close / far)

• Number of Occurrences:

• Comments

• Photo

  Media

• Not Visible

• Number of Occurrences:

• Comments

• Photo

  Media

• Wrong Sign

• Number of Occurrences:

• Comments

• Photo

  Media

• Condition Marginal

• Number of Occurrences:

• Comments

• Photo

  Media

• Condition Unacceptable

• Number of Occurrences:

• Comments

• Photo

  Media

• Signs Out of Order

• Number of Occurrences:

• Comments

• Photo

  Media

• Permanent Signs Not Covered

• Number of Occurrences:

• Comments

• Photo

  Media

• Unapproved Signs Used / Too Small

• Number of Occurrences:

• Comments

• Photo

  Media

• Sign on Wrong Side

• Number of Occurrences:

• Comments

• Photo

  Media

• Sign Too Low

• Number of Occurrences:

• Comments

• Photo

  Media

• Speed Restriction / Derestriction Not Appropriate or Inconsistent

• Number of Occurrences:

• Comments

• Photo

  Media

• Speed Limit Not Correctly Aligned

• Number of Occurrences:

• Comments

• Photo

  Media

• Sign Not Upright

• Number of Occurrences:

• Comments

• Photo

  Media

• Non-Compliant Support (base or stand)

• Number of Occurrences:

• Comments

• Photo

  Media

• Lateral Location

• Number of Occurrences:

• Comments

• Photo

  Media

• Sign Ballast Inadequate or Inappropriate

• Number of Occurrences:

• Comments

• Photo

  Media

Delineation Devices

• Missing tapper (leading tapper)

• Number of Occurrences:

• Comments

• Photo

  Media

• Missing Tapper (trailing tapper)

• Number of Occurrences:

• Comments

• Photo

  Media

• Missing Chicane

• Number of Occurrences:

• Comments

• Photo

  Media

• Chicane Not Installed correctly

• Number of Occurrences:

• Comments

• Photo

  Media

• Missing or Ineffective Delineation Along Lanes

• Number of Occurrences:

• Comments

• Photo

  Media

• Tappers to Short or Ineffective (leading tapper)

• Number of Occurrences:

• Comments

• Photo

  Media

• Tappers to Short or Ineffective (trailing tapper)

• Number of Occurrences:

• Comments

• Photo

  Media

• Spacing Between Multiple Tappers

• Number of Occurrences:

• Comments

• Photo

  Media

• Spacing in Tapper

• Number of Occurrences:

• Comments

• Photo

  Media

• Spacing in Lanes

• Number of Occurrences:

• Comments

• Photo

  Media

• Condition Marginal

• Number of Occurrences:

• Comments

• Photo

  Media

• Condition Unacceptable

• Number of Occurrences:

• Comments

• Photo

  Media

• Missing or Ineffective Delineation Along Lanes

• Number of Occurrences:

• Comments

• Photo

  Media

• Used Incorrectly

• Number of Occurrences:

• Comments

• Photo

  Media

• Road Marking Incorrect At Long Term Level 2 or 3 Roads

• Number of Occurrences:

• Comments

• Photo

  Media

• Inadequate Access

• Number of Occurrences:

• Comments

• Photo

  Media

Miscellaneous

• Working in Live Lanes

• Number of Occurrences:

• Comments

• Photo

  Media

• Flashing Beacons Not Used / Ineffective

• Number of Occurrences:

• Comments

• Photo

  Media

• High Visibility Garment Not Warn / Not Acceptable

• Number of Occurrences:

• Comments

• Photo

  Media

• Parking / Stopping Features Not Relocated

• Number of Occurrences:

• Comments

• Photo

  Media

• Unsafe and Illegal Parking of Plant / Equipment / Vehicles

• Number of Occurrences:

• Comments

• Photo

  Media

• Poor Surface Condition

• Number of Occurrences:

• Comments

• Photo

  Media

• Safety (lateral and/or Longitudinal) Zone Compromised

• Number of Occurrences:

• Comments

• Photo

  Media

• VMS Message Incorrect or Inappropriate

• Number of Occurrences:

• Comments

• Photo

  Media

• Excavation Not Protected

• Number of Occurrences:

• Comments

• Photo

  Media

• Barrier Defects (missing or incorrect components)

• Number of Occurrences:

• Comments

• Photo

  Media

• Inadequate Property Access

• Number of Occurrences:

• Comments

• Photo

  Media

Pedestrians / Cyclists

• Inadequate Provisions For Pedestrians

• Number of Occurrences:

• Comments

• Photo

  Media

• Inadequate Provisions For Cyclists

• Number of Occurrences:

• Comments

• Photo

  Media

Mobile and Semi Static Operations

• Tail Pilot Vehicle Omitted or Incorrect Location

• Number of Occurrences:

• Comments

• Photo

  Media

• Lead Pilot Vehicle Omitted or Incorrect Location

• Number of Occurrences:

• Comments

• Photo

  Media

• Shadow Vehicle Omitted or Incorrect Location

• Number of Occurrences:

• Comments

• Photo

  Media

• Vehicle Mounted Signs (missing or incorrect)

• Number of Occurrences:

• Comments

• Photo

  Media

• TMA Missing or Non-Compliant

• Number of Occurrences:

• Comments

• Photo

  Media

• Arrow Board Missing

• Number of Occurrences:

• Comments

• Photo

  Media

• Arrow Message Missing or Incorrect

• Number of Occurrences:

• Comments

• Photo

  Media

Action Traffic Additional Requirements

• Incorrect PPE Gear for Specific Site

• Number of Occurrences:

• Comments

• Photo

  Media

• Incorrect Uniform Items / Uniform Items Not Worn Correctly

• Number of Occurrences:

• Comments

• Photo

  Media

• Transit Cards Not Held On Person (for STMS and all TC's on site)

• Number of Occurrences:

• Comments

• Photo

  Media

• Hazard ID Not Filled Out Thoroughly

• Number of Occurrences:

• Comments

• Photo

  Media

• TMP Amendments Not Noted, Dated and Signed

• Number of Occurrences:

• Comments

• Photo

  Media

• Poor Customer Service (client liaison / communication)

• Number of Occurrences:

• Comments

• Photo

  Media

• Cones Not Turned So Logo Faces Oncoming Traffic

• Number of Occurrences:

• Comments

• Photo

  Media

Summary

• Comments:

• Site Photos

  Media