• Document No.

  • Road Name

  • Type of Road (Sealed or Unsealed)

  • Conducted on Month/ Date/Year

  • Prepared by

  • Location


  • Has a Defect been Found

  • Type of Defects Found ( potholes, corrugations, guide post eg.)

  • Action Required

  • Defect Rating (High, Medium, Low)

  • Works instruction.

  • Add media

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.