Title Page

  • Conducted on

  • Prepared by

  • Location
  • Date:

  • Project

  • Client:

  • Project Number:

  • Contractor:

  • Site Conditions

Safety

  • Is correct PPE being used?

  • Are TTM’s in place if required?

  • Are materials being stored safely?

  • Are there any overhead power lines on site?

  • Are there any other safety concerns? If so detail, photograph and assign actions. Note: If there is an immediate risk to a persons safety then instruct the work to stop and contact the person in charge as well as Spiire Construction Team.

Environmental

  • Is contractor working in accordance with the approved EPA drawings?

  • Has there been any spills or leaks of hot asphalt mix, solvents or additives?

  • Has there been any spills or leaks of fuels or lubricants?

Material

  • Is the contractor working to the correct revision of drawings?

  • Is the select layer material approved?

  • Are the subbase and base layers material approved?

  • Has grading test for materials been received?

  • Is the primer approved?

Testing

  • Has sufficient compaction testing been done on base layer and does it comply?

  • Has sufficient compaction testing been done on sub base layer and does it comply?

  • Has sufficient compaction testing been done on select layer and does it comply?

  • Is moisture content within range for base, sub base and select materials?

Priming

  • Is primer required?

  • Has primer been placed appropriately with no wet areas?

Placement of Asphalt

  • Has existing surface been thoroughly swept?

  • Is pavement dry before placement?

  • Is correction course required to any areas?

  • Is pavement temperature sufficient to lay asphalt?

  • Does the pavement plan and equipment used minimise cold joints?

  • Were there any paver stoppages during placement?

QA

  • Have compaction and density test been done prior to placement and do they comply?

  • Is asphalt consistent with no segregation or bony sections?

  • Is ride ability acceptable?

  • Are joints acceptable?

  • Does level match existing?

  • Comments:

  • Name:

  • Role:

  • Signature:

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.