Title Page
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Local Government:
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Road Name (Section):
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Project Location: (T. Dist, GIS coordinates, where applicable)
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Project Number:
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Existing Conditions
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Speed Limit:
- 30 km/h
- 40 km/h
- 50 km/h
- 60 km/h
- 70 km/h
- 80 km/h
- 90 km/h
- 100 km/h
Road Features:
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Comments:
Intersection to Intersection:
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Comments:
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Curb and Channel Type:
- Curb and Channel
- Barrier Kerb
- Mountable kerb
- Semi Mountable Kerb
- Invert
- Edge Restraint
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Curb and Channel Type:
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Invert Type:
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Barrier Type:
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Semi Mountable Type:
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Mountable Type:
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Edge Restraint Type:
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Attach Photo:
Width:
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Seal Width:
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Formation Width:
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Attach Photo:
Alignment:
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Horizontal=
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Vertical=
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Attach Photo:
Intersection/Property Access:
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Intersection:
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Property Access:
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Drainage Structures:
- FC-310-01 - Road Gully Unit - Kerb In Line (Protruded) - Precast Inlet Unit
- FC-310-02 - Road Gully Unit - Lip In Line (Recessed) - Precast Inlet Unit
- FC-310-03 - Road Gully Unit - Lip In Line - Keysin unit
- FC-310-04
- FC-310-05
- FC-310-06
- FC-310-07 - Domestic & Shed Roofwater - Onsite Soakage Pit
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RCPs =
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Roadside pits =
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Chambers =
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Attach Photo:
Road Conditions:
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Roughness Range from __ to __ with an average of __,__% of the roughness is above the average (_).
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Intervention Level is __,__% of the identified roughness is above the intervention level.
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Rutting Range is from __ to __ with the average being __,__% of the rutting is above the average.
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Pavement:
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Crash history:
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AADT (% of heavy vehicles / growth):
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Deficiencies:
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Political and community issues:
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Benefits / outcomes of proposed work:
What is the proposed scope?
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Comments:
What is identified in the scope?
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Comments?
What is not included in the scope?
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Comments:
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Significant risks identified:
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Native Title?
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Is it of concern?
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Comments:
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Environment?
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Is it of concern?
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Comments:
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Cultural Heritage?
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Is it of concern?
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Comments:
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Native Title / Environment / Cultural Heritage concerns:
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Project Estimate:
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Prepared by:
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Checked / Approved By:
