Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Asset Information

  • DOT #

  • Milepost

  • Photo of Case from Crossing

Asset Details

  • Type of Case

  • Type of Equipment

  • Type of Detection

  • Special Equipment

  • Photo of Inside of Case

Stand-By Power

  • Battery Location (Bank 1)

  • Type of Rectifier (Bank 1)

  • Type of Batteries (Bank 1)

  • Number of Batteries (Bank 1)

  • Battery Location (Bank 2)

  • Type of Rectifier (Bank 2)

  • Type of Batteries (Bank 2)

  • Number of Batteries (Bank 2)

Approaches

  • West Approach Length (in feet)

  • West approach shunt type and frequency (if applicable)

  • East Approach Length (in feet)

  • East approach shunt type and frequency (if applicable)

  • Primary Battery Locations (if Applicable)

Flashers

  • Crossing Protection

  • Type of Lamps in Flashers

  • Number of Light Pairs

  • Cantilever

Utilities

  • Photo of Power Meter

  • Power Meter Location

Crossing Information

  • Crossing Surface

  • Number of tracks through crossing

  • Lanes of Traffic (including Turn Lane)

  • Photo of Crossing Surface

  • Photo Looking North from Crossing

  • Photo Looking East from Crossing

  • Photo Looking South from Crossing

  • Photo Looking West from Crossing

  • Posted Speed Limit

  • Is there Additional Lighting at Crossing

  • What Signs are Posted at and/or around the Crossing?

  • RR Emergency Contact Numbers

  • Is the DOT # Posted on the Case

  • RR Advanced Warning Signs

  • Pavement Markings

  • Yield Sign

  • Stop Sign

  • Traffic Signals

  • Pre-emption on Traffic Signals?

Other

  • Has the Case been Weatherized?

  • Is the Case Clean?

  • Does the case need painted?

  • Does the case need new Battery Mats?

  • Is there Bug/Mice Poison in the Case?

  • Do the hoods/roundels need painted?

  • Does the Battery Tub need Painted or Sealed?

  • Does the Battery Tub Need New Battery Mats?

  • Are there temporary wires to bury at this location?

  • List any additional repairs needed at this location

  • Have the shunt locations and insulated Joints been marked with paint?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.