Information

  • State Forest , compartment numbers

  • Conducted on

  • Inspected by

  • Contractor/Crew

General - this is to be assessed for overall roading plan

  • Site Safety Plan in place. Guidance - check for traffic management (including signs), operator inductions, hazard assessment and control.

  • Toolbox talks. Guidance Evidence of toolbox talks completed (iform, or on safety plan diary)

  • Operational Plan on site, with induction records

  • Add media

  • Quarry site safety plan onsite. If using FCNSW quarry a quarry site safety plan must be onsite at the quarry with all oeprtors inducted, communications tested and traffic management plan in place. Quarry returns done.

  • Add media

  • Contractor performance reviews completed. Guidance: contractor KPI are to be completed using iforms.

  • Add media

  • Operational Compliance Monitoring completed?

  • Add media

  • Cost Tracking in place. Guidance - if not completed within a month of job completion please give reasons.

  • Add media

  • Road batters stable? Guidance: no significant slumping (>10cu m) or delivering sediment to drainage feature

  • Add media

  • Site specific Roading plan conditions implemented on newly constructed or upgraded ground on road slopes >30 deg. Guidance: refer to EPL sch 5 cond 24-29

  • Site specific erosion and sediment control measures implemented as per Roading plan and maintained. Guidance: refer to EPL sch cond 10 a-e

  • Site specific mass movement conditions implemented as per Roading plan. Guidance: refer to EPL shed 5 cond 30-32

  • choose a section of road for general road assessment - Road Name and location

  • Length of road assessed?

  • Length of road not significantly deformed

  • Proportion of the road not significantly deformed (b-a) *100

  • Very poor

  • Poor

  • Acceptable

Road Crossing

  • To be checked?

  • crossing
  • Crossing name

  • Drainage feature type

  • Structure type

  • Road surface and table drain drained at 5-30m (not outfall) or site specific techniques employed to prevent water pollution and road drained at first possible opportunity. Note mandatory on drainage lines and watercourses. Use on drainage depressions where practical. Guidance: refer to EPL sch 5 cond 38

  • Crossing stable. Guidance causeways must be replaced or armoured if erosion or deformation occurs, gully stuffers must be removed if they become unstable during operation

  • Drainage features, filter strips, protection zones and buffer zones clear of spoil and debris. Disturbed areas re shaped and stabilised.

  • Fill batters stabilised where toe of fill enters filter strip or protection zone. Guidance: measures to stabilise the toe may include >70% ground over or artificial cover such as geotextile or erosion control mats

  • Bridge embankments protected from table drain discharge and structures installed to prevent bridge pavement from entering drainage feature. Bridge stable.

  • Culvert outlet stable, fill batter stabilised around pipe, inlet/outlet clear of fill material and structures installed to prevent culvert pavement entering drainage feature

  • Causeway surface, on upstream and downstream side is no more than 100mm higher than invert level of drainage feature (fish passage). Causeway is stable.

  • Temporary erosion control in place. Guidance: where rainfall is forecast during construction or upgrading the crossing, the risk of sediment entering the drainage feature is high. Installation of temporary sediment control measures will reduce this risk

  • Crossing constructed as per Roading plan including implementation of any site specific conditions.

  • Number of items checked

  • Numbers of items conforming

  • Percentage of conformance (b-a)*100

  • Poor ( no environmental harm) or very poor (material harm actual or potential)

  • Satisfactory

road Drainage

  • To be checked?

  • Road name

  • Section

  • Add media

  • Guidance: target sections of road where connectivity to the drainage network is high (ie crossing approaches, lower slopes and valley bottoms, heads of drainage features). Check of minimum of 10 drains per road. Check drainage spacing along other sections where ther is evidence of excessive scour in table drains, road pavement and drainage outlets. Check conformance with site specific conditions.

  • Drain number

  • drain number
  • Slope

  • Spacing - actual

  • Meets required?

  • Structure type (inc outfall)

  • Structure height or size - actual

  • Meets required?

  • Outlet stable?

  • Clear of harvest debris or spoil?

  • Away from snig track?

  • Number of drains checked?

  • Number of drains that comply

  • Proportion of compliant drainage

  • Acceptable

  • Poor

  • Very poor

Summary and learnings

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.