CCTV Feasibility Study

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Site Information

• Investigation Date

  Date

• Intersection Location

• Controller ID

• Number of Posts at Intersection

  Select 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 N/A

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • N/A

• Overhead Power Line Present

  No

  Yes

• Other ITS Devices at Intersection

  Select None Red Light Camera VMS Speed Signs Traffic Light Warning Sign Flood Warning Sign Vehicle Height Detectors Other Cameras Rapid Signs VID

  • None
  • Red Light Camera
  • VMS
  • Speed Signs
  • Traffic Light Warning Sign
  • Flood Warning Sign
  • Vehicle Height Detectors
  • Other Cameras
  • Rapid Signs
  • VID

• Other Services at Intersection

  Select Gas Pipes Sewers Energex Mains Telstra Services Water Mains Optus Cables None

  • Gas Pipes
  • Sewers
  • Energex Mains
  • Telstra Services
  • Water Mains
  • Optus Cables
  • None

• Note: Please refer to DBYD for more information on existing services at the location.

• Photos of Other Services or ITS Devices

  Media

• Comments

Pre-Start Checks

• Site Risk Assessment Completed

  Yes

  No

Cabinet Information

• Cabinet Details

Cabinet

• Cabinet Type

  Select Tyco EC1 Phillips MKII Tyco PSC MKIII QTC Alpha 16 Mux Cabinet Pole Cabinet Other N/A

  • Tyco EC1
  • Phillips MKII
  • Tyco PSC MKIII
  • QTC
  • Alpha 16
  • Mux Cabinet
  • Pole Cabinet
  • Other
  • N/A

• Top Hat Installed

  Yes

  No

  N/A

• Controller Control Module

  LCM

  TIC

• Blue Tooth Installed with Shark Fin

  Yes

  No

  N/A

• Describe Cabinet Type

• Cabinet ID

• Communications

  Fibre

  ADSL

  3G

  Other

• Describe Communications Method

• Ethernet Switch Installed

  Oring

  Other

  N/A

• Describe Switch

• Fibre Patch Panel Installed

  Tyco RTC1G

  AFC

  Other

  No

• Fibre Type

  SM

  MM

• Describe Fibre Setup

• Accurate As Con Plan Available

  Yes

  No

  N/A

• Plan Drawing Number and Issue Number

• Additional Circuit Breakers Installed

  Yes

  No

  N/A

• Photos of Cabinet

  Media

• Comments

Camera Location Audit

• Take at least one photo of each post at the intersection even if it is not suitable for a new camera.

• Location Details

Location

• Signal Post Number

  Select 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 N/A

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • N/A

• Post Type

  J/U

  Mast Arm

  Pedestal

  Other

  N/A

• Obstructions

  Select None Trees Signage Lanterns Poles Power Lines Other Electronic Signs

  • None
  • Trees
  • Signage
  • Lanterns
  • Poles
  • Power Lines
  • Other
  • Electronic Signs

• Lane Closure Required to Access Location

  No

  Yes

• Equipment Required to Access Location

  > 20m Crane

  15m Crane

  EWP

  Ladder

• Photos of Location

  Media

• Photo File Name on CD or USB (e.g Location 1 - Post 12 - 01.jpg)

• 360 Degrees Video Footage Taken at Approx. 6.1m

  Yes

  No

• Video File Name on CD or USB (e.g Location 1 - Post 12.avi)

• Location Suitability for Camera (Rating 1 to 10)

• Comments

Pit Audit

• Please open, take photos and inspect ALL pits at the intersection.

• No. of Pits at Location

  Select 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 N/A

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • N/A

• Pit Details

Pit

• Pit Number

  Select 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 N/A

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • N/A

• Photo of Pit

  Media

• Pit Type

  4

  8

  Gatic

  Round

• Pit Construction

  Plastic

  Fibro/Asbestos

  Cement/Asbestos

• Pit Surrounding Surface

  Select Grass/Dirt Bitumen Pavement Pebbles

  • Grass/Dirt
  • Bitumen
  • Pavement
  • Pebbles

• Entry Conduit Depth (mm)

• Entry Conduit Percentage Full

• Exit Conduit Depth (mm)

• Exit Conduit Percentage Full

• Pit Condition

  Good

  Broken Lid

  Collapsing

  Full

• Pit Number Referenced on Plans

• Pit Photo File Name on CD or USB (e.g Pit 5 - 01.jpg, Pit 5 - 02.jpg etc)

• Comments

Audit Recommendations

• Location Originally Nominated by CPO

  Select 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 N/A

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • N/A

• Corresponding Signal Post No. Originally Nominated by CPO

  Select 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 N/A

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • N/A

• Location Recommended by FSG

  Select 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 N/A

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • N/A

• Corresponding Signal Post No. Recommended by FSG

  Select 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 N/A

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • N/A

• Comments

Post Documentation Checklist

• Plan Marked Up Referencing Location No. or Pit No.

  Yes

  No

• Photos of Marked Up Plan

  Media

• Video Footages Renamed Referencing Location No.

  Yes

  No

• Photos Renamed Referencing Location No. or Pit No.

  Yes

  No

• CD-Rom or USB Created with Videos, Photos & Plan

  Yes

  No

• Comments

• Auditor signature

  Sign