Title Page
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Site conducted
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Site Number
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Site Number is to be painted on the road at each end of the site.
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Conducted on
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Prepared by
Location
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Map the Location of the Barrier, Work in the Forward Direction starting at the beginning of the barrier and try to mark each point it changes direction along the length. Make sure you capture the Start and End Points where the terminal begins.
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Location of Barrier
Site Details
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Road Name
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Direction of Travel
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Start Chainage (km)
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Photo of start location
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End Chainage (km)
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Photo of end location
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Speed Zone of Site (km/h)
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What is the Priority of the Site?
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Example of Scoring Criteria
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Other Site Photo’s
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Sketch
Lane
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All measurements are in meters (m), only record the number without any symbols (m) e.g. 1.1
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Lane Width (adjacent)
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Lane Width (opposite)
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Shoulder Width (adjacent)
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Is the shoulder sealed (adjacent)?
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What is the width of the sealed Shoulder (adjacent)?
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Shoulder Width (Opposite)
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Is the shoulder sealed (Opposite)?
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What is the width of the sealed shoulder (Opposite)?
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Verge Width (adjacent)
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Verge Width (opposite)
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Photo's of lanes, verge and shoulders
The Hazard
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What is the offset to the hazard from the adjacent edge line ?
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What is the offset to the hazard from the centre line?
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What is the depth of the hazard (front to back)?
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What is the length of the hazard (Left to Right) start to finish?
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Diagram of Hazard / Road
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Length of need from the hazard (adjacent)
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Length of need from the hazard (opposite)
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Add any clarifying comments here for example "The hazard is a tree, trunk diameter is .6m" then place a photo below.
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Comments about the Hazard
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If the Hazard is a drop off how deep is the drop off in meters?
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Photo’s of hazard
The Barrier
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Marking the Barrier on the Road
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Length of barrier excluding terminals
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What is the intended offset to the front of barrier from the edge line?
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Approach terminal type
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Is this terminal to be flared if possible? (Approach)
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Is there a Maintenance break before this terminal? (Approach)
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Is there an existing terminal here? (Approach)
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What needs to be removed? (Approach)
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Departure terminal type
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Is this terminal to be flared if possible? (Departure)
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Is there a Maintenance Break after this Terminal? (Departure)
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Is there an existing terminal here? (Departure)
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What needs to be removed? (Departure)
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Desirable offset is 4.0m - 6.0m,
minimum offset is 3.0m (without sign off)
Absolute minimum is .5m (requires sign off) -
Is the length of barrier longer than 500m?
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Is there room for a vehicle pullover area?
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What is the width of the potential pull over area?
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Ideal length would be 15m taper / 50m bay / 15m taper at 4m offset
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How many meters from the approach terminal does the taper for the pull over area start?
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What is the Approach taper length?
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What is the length of the potential pull over area?
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What is the Departure taper length?
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Photo's of pull over location
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Does the barrier require longer posts or more posts? Explain in comments below.
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Number of Posts
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Comments
Flaring of Barrier
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(m) from the start of barrier
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Length (m)
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Offset from edge line (m)