Title Page

  • Appendix "A"

  • Workgroup

  • Site Location
  • Site Name

  • Site Number

  • Conducted on

  • Prepared by

Report Items

  • Plan No.:

  • Job No.:

  • Contractor:

Switch on Items

  • Lanterns Aimed

  • Old Hardware Removed

  • Old Meter Box Removed

  • Traffic signs

  • Parking Signs

  • Police Control

  • Flashing Yellow

  • All Globes Working

  • Controller Operation

  • Controller Operation Sheet

  • Controller Fault Card

  • Controller Locks

  • Controller Stickers

  • Vehicle Detection

  • Pedestrian Detection

  • Advanced Tram Detection

  • Telstra Line

  • Railway Link

  • Line Marking, RPM, RRPM

  • Pavement Reinstatement

  • Site Clean & Tidy

  • Pram Crossings

  • Tree Trimming

  • Public Lighting

  • Pedestrian Fences

  • Red Light Camera

  • Council, Region Attendance

  • Accident Free Site

  • Audios Fitted/Type N C V

  • Type

  • Notes

  • Remodel

Power Consumption

  • Volts

  • min A

  • max A

  • Site Photos

Sign Off

  • DoT Officer

  • Date & Time

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.