Asphalt Report

• Project Description

• Job Number

• Weather Conditions

  Fine

  Mostly Fine

  Overcast

• SCC-CWS-CM-001

• Conducted on

  Date

• Prepared By

  Jeff Willersdorf

  Kev Hancock

  Mick Ammenhauser

  Tim Brock
• Location
  Address

Asphalt Contract Works

• Principal Contractor:

  Allroad Surfaces

  Downer Edi

  Tropic Asphalts

  Allens Asphalt

• Sub-contractor:

  Allroad Surfaces

  Downer Edi

  Tropic Asphalts

  Allens Asphalt

Tack Coat

• Tack Coat

  Select Yes No

  • Yes
  • No

• Comments

Type of Road Defect Correction

• Full Correction

  Select Yes No

  • Yes
  • No

• Add media

  Media

• Depth in mm

• Location
  Address

• Comments

• Trench Crossing

  Select Yes No

  • Yes
  • No

• Add media

  Media

• Depth in mm

• Location
  Address

• Comments

• Running Lane Depressions

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Add media

  Media

• Depth in mm

• Location
  Address

• Comments

• Sunken & Low Areas

  Select Yes No

  • Yes
  • No

• Add media

  Media

• Depth in mm

• Location
  Address

• Comments

Pre-Start Inspection

WH&S Requirements:

• All personnel at site have been inducted and signed on?

• Records of toolbox talks available?

• All personnel are equipped with appropriate PPE?

• First Aid Kits and Nominated First Aiders are available on site?

• Fire extinguishers readily available on site?

• Spill kits available on site?

Traffic Management Measures:

• Is provision for the following adequate:<br><br>▶ Signage<br><br>▶ Traffic Cones<br><br>▶ Flag Persons

  Yes

  No

• Comments (i.e. single lane, contraflow, closed with detours)

• Pre-start comments:

Post Work Inspection

Condition of Work:

• Is there any defects

  Yes

  No

• Defect 1:

  Media

• Defect 2:

  Media

• Damaged Surfaces

  Acceptable

  Conditional

• Add media

  Media

• Comments

• Temporary markers installed?

  Yes

  No

  N/A

• Adequate after-care signage installed?

  Yes

  No

  N/A
• Location:
  Address

• Add media

  Media
• Location:
  Address

• Add media

  Media
• Location:
  Address

• Add media

  Media
• Location:
  Address

• Add media

  Media

• Site cleanliness?

  Acceptable

  Conditional

• Further Comments:

Recommendations:

• Enter comments or recommendations:

• Contractor Performance:

  Very Poor

  Poor

  Average

  Good

  Very Good

• SCC Representative:

  Sign

• Did you Receive Quantity Agreement Sheet

  Select Yes No

  • Yes
  • No