Title Page
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Site:
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Location:
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Date & Time:
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Number of Barriers Replaced:
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• Sizes:
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Prepared by:
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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
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A. ENSURE BARRIER WAS INSTALLED IN CORRECT DIRECTION & 48” MAXIMUM TO ADJACENT FORCE PROTECTION
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B. ENSURE ALL SAFTEY LOOPS ARE CUT IN AND SEALED. INSTALLED AT LEAST 2’ FROM BARRIER.
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C. SAFETY LOOP DIMENTION (4’ in width, 6’ in length/may vary)
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D. 2 EACH STABILIZER BAR INCLUDED WITH EACH BARRIER/SIZE
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E. BARRIER DRAIN PIPES
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F. SOUND DAMPENING MATS
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G. STOP DECAL
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H. BARRIER IS FLUSH WITH PAVEMENT WHEN FULLY UNSECURED. ENSURE CONCRETE PAD HAS NO DEFORMATION
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I. BARRIER HEIGHT 33” +- (1”) ABOVE GRADE
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J. BARRIER KNEE BRACES AND FLAPS SECURELY FASTENED
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K. BARRIER APPEARANCE
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L. BARRIER HYDRAULIC HOSE REPLACED AS NECESSARY
II. BARRIER FUNCTION
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A. TEST BARRIER UP CYCLE (4 SECONDS)
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B. TEST BARRIER DOWN CYCLE (4 SECONDS)
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C. TEST BARRIER E-UP CYCLE (2 SECONDS)
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D. E-UP ANUNCIATOR (ALARM IN BOOTH) FUNCTIONAL
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E. ENSURE GREEN/POSITION INDICATOR LIGHTS IN BOOTH FUNCTION CORRECTLY (INTERNAL)
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F. ENSURE TRAFFIC LIGHTS ARE OPERATING CORRECTLY (EXTERNAL)
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G. TEST ALL SAFETY LOOPS FOR PROPER OPERATION
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H. TEST MASTER CONTROL PANEL OPERATION (INCL. PUSH AND HOLD UP – FUNCTIONAL)
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I. GATE ARM OPERATES IN SEQUENCE WITH THE BARRIER
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J. ENSURE SNOW MELT SYSTEM IS FUNCTIONAL
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K. BARRIER ALARM FUNCTIONAL (USCP)
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L. ENSURE BARRIER OPERATES ON BATTERY BACK UP WITHOUT A/C POWER. (NOT TO EXCEED 100 CYCLES) (Dual Chargers)
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M. BARRIER ALARM FUNCTIONAL (USCP)
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N. ENSURE BARRIER OPERATES ON BATTERY BACK UP WITHOUT A/C POWER. (NOT TO EXCEED 100 CYCLES) (Dual Chargers)
SIGN-OFF
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NASATKA Rep's Name & Signature:
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USCP Rep's Name & Signature:
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AOC Rep's Name & Signature: