Audit

Instructions

1. Fill out any needed information on the blank spaces
2. Select the best response for the items with the given choices below
3. Add photo, comments & notes by clicking on the paperclip icon
4. To add corrective actions to any item with issues, click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date
5. Complete the audit by providing digital signature
6. Share your report by exporting as PDF, Word, Excel or Web Link

Operational Details

• Activity description

• TTM method

• TTM Contractor

• Contractor- working space

• Client / Principal

Signs

A1 - Missing

• Sign

A2 - Position

• Sign

A3 - Not visible/fallen over

• Sign

A4 - Wrong sign

• Sign

A5 - Condition unacceptable

• Sign

A6 - Permanent sign

• Sign

A7 - Unapproved sign used / too small

• Sign

A8 - Non-compliant support / sign too low

• Support

Mobile & Semi-Static

B1 - Tail pilot vehicle/AWVMS omitted or incorrect location

• Vehicle

B2 - Lead pilot vehicle omitted or incorrect location

• Vehicle

B3 - Shadow vehicle omitted or incorrect location

• Vehicle

B4 - TMA missing or non-compliant

• TMA

B5 - AWVMS/arrowboard non-compliant

• Vehicle

Pedestrians / Cyclists

C1 - Inadequate provision for pedestrians

• Feature

C2 - Inadequate provision for cyclists

• Feature

Delineation

D1 - Missing or ineffective taper Leading

• Taper

D2 - Tapers too short Leading

• Taper

D3 - Taper too short or missing Trailing

• Taper

D4 - Spacing in taper

• Taper 5

D5 - Spacing along lanes

• Per 100m

D6 - Missing or ineffective delineation along lanes

• Per Section

D7 - Condition unacceptable

• Device

D8 - Using non-approved device

• Device

D9 - Road marking incorrect at long-term level 2 or 3 roads

• Site

D10 - Inadequate/missing site access

• Access

Miscellaneous

E1 - Working in live lanes

• Individual

E2 - Missing or ineffective controller

• Individual

E3 - Safety zone compromised

• Individual

E4 - High visibility garment not acceptable

• Individual

E5 - Marginal surface condition (carriageway only)

• Occasion

E6 - Unacceptable surface condition (peds, cyclists or carriageway)

• Occasion

E7 - Barrier defects (missing or incorrect components)

• Component

E8 - Unsafe or redundant TTM

• Equipment

E9 - VMS message incorrect or inappropriate

• VMS

E10 - Flashing beacons / indicator lights not used or ineffective

• Vehicle

E11 - Parking / stopping features not relocated

• Feature

E12 - Unsafe and illegal parking of plant/equip.

• Feature

E13 - Marginal items (signs, delineators, Hi vis garments)

• Feature

Other Worksite Aspects

G1 - Qualified person on site [refer to A5 of CoPTTM]

G2 - TSL appropriate [refer to C4 of CoPTTM]

G3 - Road user flow acceptable

G4 - On-site record [form must include STMS authority, 2 hourly checks and TSL details]

G5 - TMP approved?

G6 - Approved TMP sighted?

G7 - Approved TMP applicable?

G8 - TTM in accordance with approved TMP?

Result & Findings

Rate

Site fixed?

Has site activity been ceased?

Site activity ceased by

Key Points & Actions

Complaint callout

Site Activity Status

Audit / Review

Notification to RCA

Good site induction

TMP design issues

Low Risk

General Key Point Notes

General Action Notes

STMS Details
Received by (Name and Signature)

SCR left onsite?

STMS Name

Qualifications

NZTA ID No.

STMS Mobile No.

Audit / Review Completion & Sign-Off
Auditor's Name and Signature

NZTA ID No.

Qualifications

Auditor Mobile No.