Title Page
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Start Date
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Lot Description
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Finish Date
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Contractor Name
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ITP- Lot Number
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Chainage Start
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Chainage End
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Offset Left
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Offset Right
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Works Engineer
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Works Co-ordinator
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Team Leader
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Job/ Works Name
1 -Pre-Construction
1.1 - Approval of Construction Documents
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Please Identify if the following Documents are in place and sighted.
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Safe Work Method Statement (SWMS)
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Traffic Management Plan (TMP)
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Traffic Control Plan (TCP)
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Erosion & Sediment Control Plan (ESCP)
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Safe Operating Procedures (SOP)
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Chemical Safety Data Sheet (SDS)
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Pre-start and Toolbox blank pro-formas
LCC ITP
1.2 - Setting out earthworks limits as per the design drawings.
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Confirm that the survey stations are set up on-site and sufficient data is shown to enable construction and completion of works as executed in drawings.
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Photograph (or attach) survey report
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Comments
1.3 -Approval of waste classification and location of stockpiles & waste sites.
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Any material requiring offsite disposal will require waste classification assessment in accordance with Department of Environment and Climate Change Waste
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Overburden Material stockpiled at:
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Waste Material stockpiled at:
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Photograph (or attach) receipts
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Signed By
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Comments
1.4 Approved fill materials
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Fill material must comply with specifications in the drawings
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Clays of high plasticity or high in-situ moisture content are not to be used as fill
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Imported fill shall comprise well graded granular material with a plasticity index <15% and a CBR >15% unless otherwise approved by the nominated geotechnical engineer.
HOLD POINT (R44.- Cl 6.1.2)
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The “hold point” refers to putting a hold on construction activities until an inspection is passed. Verification of conformity of stockpiled Selected Material. (R44. Cl 6.1.2) is RELEASED.
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Hold point released by:
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Date
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Photograph (or attach) material laboratory report/ results
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Comments
1.5 - Services identified- marked out- & piloted/ confirmed.
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Services location shall be undertaken and any relevant authorities should be contacted for possible relocation or tagging.
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Current DBYD documentation Sighted
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DO NOT PROCEED WITH WORKS UNTIL REMEDIED.
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All services identified and protected on works /areas.
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DO NOT PROCEED WITH WORKS UNTIL REMEDIED.
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Signature
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Comments
2 -Pavement Preparation
2.1 Sub-grade Layer Checklist
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Is this lot capturing a sub-grade layer?
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Is the depth of the existing pavement layer as required as per the design/specification?
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Is the sub-grade layer as specified?
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Are levels as required by design?
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Comments
Witness Point (R44. Cl 7.6.1)
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Surface proof rolled with fully laden water cart or 15-18T roller.
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Witness Point Signed off by:
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Date
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Is the Sub-grade approved for next layer to commence?
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Comments
LCC ITP
2.2 Sub-base Layer Checklist
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Is this lot capturing a sub-base layer?
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Is the depth of the existing pavement layer as required as per the design/specification?
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Are surface levels as required by drawings?
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Is the Sub-base layer homogeneous?
Witness Point (R44. Cl 7.6.1)
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Surface proof rolled with fully laden water cart or 15-18T roller.
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Witness Point Signed off by:
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Comments
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Was the layer no greater than 150 mm post compaction?
Pavement layers, DGB and DGS, must achieve a minimum of 100% Standard Compaction (desirable 102%). Pavement gravels should be placed, compacted and maintained at 60% - 90% OMC. "Density testing shall be undertaken by a NATA accredited testing authority. Any material that does not meet the minimum density requirements shall be rework and retested.
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Please confirm conformity of the Lot- achieved if the lower limit of the characteristic value of relative compaction is not less 100% (RMS. T111 & T120).
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Photograph (or attach) compaction report/ results.
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Signature
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Comments
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Is the Sub-base approved for next layer to commence?
LCC ITP
2.3 - Base Layer Checklist
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Is this lot capturing a base layer?
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Is the depth of the existing pavement layer as required as per the design/specification?
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Are surface levels as required by drawings?
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Is the base layer homogeneous?
Witness Point (R44. Cl 7.6.1)
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Surface proof rolled with fully laden water cart or 15-18T roller.
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Witness Point Signed off by:
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Comments
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Was the layer no greater than 150 mm post compaction?
Pavement layers, DGB and DGS, must achieve a minimum of 100% Standard Compaction (desirable 102%). Pavement gravels should be placed, compacted and maintained at 60% - 90% OMC. "Density testing shall be undertaken by a NATA accredited testing authority. Any material that does not meet the minimum density requirements shall be rework and retested.
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Please confirm conformity of the Lot- achieved if the lower limit of the characteristic value of relative compaction is not less 100% (RMS. T111 & T120)
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Photograph (or attach) compaction report/ results.
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Signature
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Comments
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Is the Sub-base approved for next layer to commence?
Witness Point (R44. Cl 7.6.2)
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Ball penetration test (RMS. T271) to be undertaken prior to sealing.- Average result to be less than 3mm.
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Does the ball penetration test conform?
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Witness point released by:
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Comments
LCC ITP
3.1 -Seal Design
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Has the seal design been submitted prior to sealing for verification?
3.2 - Primer Seal
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Is this lot capturing a primer seal layer?
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Where final sealing cannot be undertaken within a few days of completion of the base course, a primer seal should be used to protect the pavement and maintain equilibrium moisture content
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Comments
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Signature
Two coat seal.
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Is this lot capturing a two coat seal layer?
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Where a two coat seal is adopted, sealing should be avoided during winter months or at times when pavement temperatures of less than 15 degrees are likely.
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Comments
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Signature
Final sweep & aftercare signage
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Ensure final sweep has been undertaken & appropriate aftercare signage is in place per TCP.
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Signature
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Comments
LCC ITP
LOT CLOSURE
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This lot is compliant with design specifications and relevant standards.
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Signature
