CUTM ON-SITE RECORD

• Conducted on

  Date

• Prepared by

• Location
  Address

• Client

• CUTMS Job Number

• On-site record must be retained with TMP for 12 months

Location Details
• Road Name
  Address
• House Number / RP
  Address

• Suburb

Working space

• Person responsible for working space

  Sign

TTM

• STMS in charge

• Name/Signature

  Sign

• TTM ID Number

• Warrant expiry date

  Date

• Time

  Date
Temporary speed limit

• Street/road name (RPs or street numbers):

• From

• To

• On

• Date / Time TSL Installed

  Date

• TSL remains in place

• Date / Time TSL remains in place

  Date

• TSL speed:

• Length of TSL (m):

• TSL removed

• Date / Time TSL Removed

  Date

Worksite monitoring

• TTM to be monitored and 2 hourly inspections documented

TTM set-up

• High-visibility garment worn by all?

  Yes

  No

  N/A

• Signs positioned as per TMP?

  Yes

  No

  N/A

• Conflicting signs covered?

  Yes

  No

  N/A

• Correct delineation as per TMP?

  Yes

  No

  N/A

• Lane widths appropriate?

  Yes

  No

  N/A

• Appropriate positive TTM used?

  Yes

  No

  N/A

• Footpath standards met?

  Yes

  No

  N/A

• Cycle lane standards met?

  Yes

  No

  N/A

• Traffic flows, OK?

  Yes

  No

  N/A

• Adequate property access?

  Yes

  No

  N/A

• TTM Setup Compliant?

  Yes

  No

  N/A

• Barrier deflection area is clear.<br>(Refer to Barrier design statement)

  Yes

  No

  N/A

• Time of TTM Setup

  Date
2 hourly checks

• High-visibility garment worn by all?

  Yes

  No

  N/A

• Signs positioned as per TMP?

  Yes

  No

  N/A

• Conflicting signs covered?

  Yes

  No

  N/A

• Correct delineation as per TMP?

  Yes

  No

  N/A

• Lane widths appropriate?

  Yes

  No

  N/A

• Appropriate positive TTM used?

  Yes

  No

  N/A

• Footpath standards met?

  Yes

  No

  N/A

• Cycle lane standards met?

  Yes

  No

  N/A

• Traffic flows, OK?

  Yes

  No

  N/A

• Adequate property access?

  Yes

  No

  N/A

• Barrier deflection area is clear.<br>(Refer to Barrier design statement)

  Yes

  No

  N/A

• Time of Site Check completion

  Date

TTM removal

• Has all TTM been removed?

  Yes

  No

  N/A

• Does TTM remain in place while unattended?

  Yes

  No

  Unattended Aftercare

  24 hour setup remains in place

• High-visibility garment worn by all?

  Yes

  No

  N/A

• Signs positioned as per TMP?

  Yes

  No

  N/A

• Conflicting signs covered?

  Yes

  No

  N/A

• Correct delineation as per TMP?

  Yes

  No

  N/A

• Lane widths appropriate?

  Yes

  No

  N/A

• Appropriate positive TTM used?

  Yes

  No

  N/A

• Footpath standards met?

  Yes

  No

  N/A

• Cycle lane standards met?

  Yes

  No

  N/A

• Traffic flows, OK?

  Yes

  No

  N/A

• Adequate property access?

  Yes

  No

  N/A

• Barrier deflection area is clear.<br>(Refer to Barrier design statement)

  Yes

  No

  N/A

• Time TTM removal completed:

  Date

• Signature:

  Sign
Adjustment made

• Adjustment made and reason for change

• Time

  Date