Title Page

  • Site:

  • Location:
  • Date & Time:

  • Number of Barriers Replaced:

  • • Sizes:

  • Prepared by:

  • INSTRUCTIONS
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    1. Please answer "OK" , "FIX" or N/A on the questions below.
    2. Add photos and notes by clicking on the paperclip icon
    3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority, and due date
    4. Complete audit by providing digital signature
    5. Share your report by exporting as PDF, Word, Excel or Web Link

I. BARRIER STRUCTURE/APPEARANCE

  • A. ENSURE BARRIER WAS INSTALLED IN CORRECT DIRECTION & 48” MAXIMUM TO ADJACENT FORCE PROTECTION

  • B. ENSURE ALL SAFTEY LOOPS ARE CUT IN AND SEALED. INSTALLED AT LEAST 2’ FROM BARRIER.

  • C. SAFETY LOOP DIMENTION (4’ in width, 6’ in length/may vary)

  • D. 2 EACH STABILIZER BAR INCLUDED WITH EACH BARRIER/SIZE

  • E. BARRIER DRAIN PIPES

  • F. SOUND DAMPENING MATS

  • G. STOP DECAL

  • H. BARRIER IS FLUSH WITH PAVEMENT WHEN FULLY UNSECURED. ENSURE CONCRETE PAD HAS NO DEFORMATION

  • I. BARRIER HEIGHT 33” +- (1”) ABOVE GRADE

  • J. BARRIER KNEE BRACES AND FLAPS SECURELY FASTENED

  • K. BARRIER APPEARANCE

  • L. BARRIER HYDRAULIC HOSE REPLACED AS NECESSARY

II. BARRIER FUNCTION

  • A. TEST BARRIER UP CYCLE (4 SECONDS)

  • B. TEST BARRIER DOWN CYCLE (4 SECONDS)

  • C. TEST BARRIER E-UP CYCLE (2 SECONDS)

  • D. E-UP ANUNCIATOR (ALARM IN BOOTH) FUNCTIONAL

  • E. ENSURE GREEN/POSITION INDICATOR LIGHTS IN BOOTH FUNCTION CORRECTLY (INTERNAL)

  • F. ENSURE TRAFFIC LIGHTS ARE OPERATING CORRECTLY (EXTERNAL)

  • G. TEST ALL SAFETY LOOPS FOR PROPER OPERATION

  • H. TEST MASTER CONTROL PANEL OPERATION (INCL. PUSH AND HOLD UP – FUNCTIONAL)

  • I. GATE ARM OPERATES IN SEQUENCE WITH THE BARRIER

  • J. ENSURE SNOW MELT SYSTEM IS FUNCTIONAL

  • K. BARRIER ALARM FUNCTIONAL (USCP)

  • L. ENSURE BARRIER OPERATES ON BATTERY BACK UP WITHOUT A/C POWER. (NOT TO EXCEED 100 CYCLES) (Dual Chargers)

  • M. BARRIER ALARM FUNCTIONAL (USCP)

  • N. ENSURE BARRIER OPERATES ON BATTERY BACK UP WITHOUT A/C POWER. (NOT TO EXCEED 100 CYCLES) (Dual Chargers)

SIGN-OFF

  • NASATKA Rep's Name & Signature:

  • USCP Rep's Name & Signature:

  • AOC Rep's Name & Signature:

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