Title Page

  • Job Number

  • Conducted on

  • Prepared by

  • Location

Report

Job Info

  • Client

  • Permission to Lay (client signature needed)

  • Crew

  • Crew Members

  • Shift

  • Weather Conditions ( Eg: Rainy 18 degrees C)

  • Pavement Sub Grade Temperature ( Use Temp Gun)

Site Pre-Checklist

  • Prestart meeting completed and risks reviewed/monitored

  • Base is free of loose material/spoil

  • Have laying levels been established? (Attach string report/ depth mark out in photos)

  • Bobcat profiler used

  • Have all joints been prepared accordingly ? ( Eg: Is there jackhammering, profiling or saw cutting needed for any finished edges)

  • Tack coat

  • Do all crew members on site have appropriate PPE? (Eg: Hard hats, Safety boots, High Vis, Long sleeves, Long pants)

  • undefined

  • undefined

Asphalt Completion - Checklist

  • Has the job been completed?

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  • Surface finish height

  • Edges ramped and made safe? (Only applies to base layer)

  • Aftercare signage needed?

  • Dockets given to

  • Is the site clean? ( Eg: All asphalt debris has been swept from all kerb areas, tie in points, loading areas, underneath asphalt carrying plant?)

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Site Info

  • Crew Start Time (On-site)

  • Break

  • Crew Finish Time (On-site)

  • Equipment Used (Eg: Cat Paver AP600, Hamm Steel Drum HD14 etc.)

  • Bobcat Profiler Cutting Time

  • General Comments (Special delays, Material quality, Client delays, Waste etc)

Photos

Pre Photos

  • Please enter Job Pre Completion Photos:

Post Photos

  • Please enter Job Post Completion Photos:

Asphalt Docket Photos

  • Please enter the Docket Photos

String Report/ Level Photos

  • Add media

ITP Form

  • Area (sqm)

  • Thickness (mm)

  • Theoretical Usage (tons)

  • Asphalt Actual Usage (Tons)

  • Wastage (Tons)

  • Tack Coat Usage (Approximate Litres)

  • Traffic Management Setup

  • Have photos been attached for pre- digout/ post asphalt?

  • undefined

  • Have depth photos been attached?

  • Temperature of asphalt to be requested at plant and recorded on asphalt dockets

  • Sub-Grade surface tack coated?

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  • Have dip tests been carried out to monitor depth of Asphalt?

  • Is the new asphalt surface finish free of puddles, low areas and defects? ( Eg: Have bony areas been addressed with fines?)

  • Has emulsion and grit/crack sealing been used to seal edges of the asphalt patch?

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  • New finished surface is level with existing road surface, and will not hold water

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  • Line Markings/ Stick and stomp temp line marking completed and safe for road users?

  • undefined

  • Asphalt cured for reopening?

  • Delivered mix is uniform in appearance

  • undefined

  • Site Backrolled and Clean

  • undefined

  • Remove Signage and Deactivate MOA

  • undefined

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.