Signs

SIGNS
Missing (including side road) - 5 for each sign
Position - 2 points for each sign
Not visible/Fallen Over - 3 points for each sign
Wrong sign - 5 points for each sign
Condition Unacceptable - 4 point for each sign
Permanent signs not covered - 5 for each sign
Unapproved signs used / too small - 4 for each sign
Non-compliant support/Sign Too Low - 2 for each support

Mobile & Semi Statics Operations

MOBILE & SEMI STATIC
Tail pilot vehicle/AWVMS omitted or incorrect location - 30 points for missing or incorrect location
Lead pilot vehicle omitted or incorrect location - 20 points for missing or incorrect location
Shadow vehicle omitted or incorrect location - 26 points for missing or incorrect location
TMA missing or non compliant - 26 points for TMA missing or non compliant when required
AWVMS/Arrowboard non compliant - 26 points for arrowboard missing when required

Pedestrians/Cyclists

PEDESTRIANS/CYCLISTS
Inadequate provision for pedestrians
inadequate provision for cyclists

Delineation Devices

DELINEATION
Missing or Ineffective Taper (Leading Taper) - 26 points where delineation is missing and required
Tapers too short (Leading Taper) - 15 points for each taper
Tapers too short or missing (Trailing Taper) - 5 points for each taper
Spacing in taper - 5 points where spacing is incorrect
Spacing along lanes (Per 100m) - 3 points where spacing is incorrect
Missing or ineffective delineation along lanes (Per Section) - 10 points for each section
Conditional Unacceptable (Per device) - 2 points for each device where classified in unacceptable condition
Using non-approved device (Per Device) - 4 points for each non-approved device
Road Marking incorrect at long term level 2 or 3 roads - 5 points where not adjusted at long term sites on Level 2 or 3 roads
Inadequate/Missing site access - 10 points for each missing or installed incorrectly

Miscellaneous

MISCELLANEOUS
Working in live lanes - 20 points for each occasion
Missing or ineffective controller - 20 point for each vehicle
Safety zone compromised - 10 points for unacceptable or no safety zone
High visibility garment not acceptable - 5 points for each individual
Marginal surface condition (carriageway only - One off) - 15 points where no provision made and required
Unacceptable surface condition (peds, cyclists or carriageway - one off) - 30 points where no provision made and required
Barrier defects (missing or incorrect components) - 10 points for each incorrect or missing barrier component
Unsafe or redundant TTM - 5 points where relocation of feature is required but has not been made
VMS message incorrect or inappropriate - 15 points for displaying incorrect information
Flashing beacons/indicator lights not used or ineffective - 3 points for not used or ineffective
Parking / stopping features not relocated - 5 points where relocation of feature is required but has not been made
Unsafe and illegal parking of plant/equip - 20 points for each
Marginal items (signs, delineators, Hi vis garments) - 1 point for each in unacceptable condition

Other Worksite Aspects

OTHER WORKSITE ASPECTS

Qualified person on site [refer to A5 of CoPTTM]

TSL appropriate [refer to C4 of CoPTTM]

Road user flow acceptable

On-site record [form must include STMS authority, 2 hourly checks and TSL details]

TMP approved?

Approved TMP sighted?

Approved TMP applicable?

TTM in accordance with approved TMP?

Final Result

FINAL RESULT

Rating = High Standard (0-10)

Rating = Acceptable (11-25)

Rating = Needs Improvement (26-50)

Rating = Unacceptable - Other (other aspects only)

Rating = Unacceptable (51+ Only)

Rating = Unacceptable - Multiple (Both 51+ and Other Aspects)

Rating = Dangerous (SCR 51+ and Low Risk? rated No)

Actions Planned By STMS

Site Fixed?

Site Activity Ceased By

Key Points

KEY POINTS

Complaint Callout?

Site Activity Status

Audit Review

Notification To RCA (does not affect score)

Good Site Induction? (does not affect score)

TMP Design Issues?

LOW RISK?

Actions To Be Taken

ACTIONS TO BE TAKEN

Agreed Actions To Be Taken

AUDITED/REVIEWED BY
Signature
Auditor/Reviewer Name
Qualifications

NZTA ID No.

Auditor Mobile Number

STMS DETAILS
Received by/Signed

STMS Name

Qualifications

NZTA ID No.

STMS Mobile Number

SCR Left Onsite?

In submitting this form, the auditor/reviewer specified above agrees that they have explained the significant issues and proposed remedies to the relevant parties specified above and have provided these parties a physical copy of the audit (does not apply for unattended sites)