Title Page
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Site ID
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Conducted on
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Prepared by
Location
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Road Name
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Road Number
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RMC
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Direction
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MABC
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MABC Number
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Municipality
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SRRS Start (m)
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SRRS End (m)
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KM Start (km)
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KM End (km)
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GPS Start
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GPS End
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General Location comments
Inspection - Existing
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Existing surface
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Other surface
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Existing aggregate size
- 5
- 7
- 10
- 14
- 20
- 14/7
- 20/7
- Other
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Other size
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Extent of cracking
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Extent of patching
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Priority
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Major Structures
Structure Number
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Structure Number
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Minor culverts
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Mark on sketch and add to AMIS if not there
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Pits and Valves
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Mark on sketch
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Kerb and Channel
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Residential area
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Businesses in vicinity
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Farms in vicinity
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Emergency facilities in vicinity
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In town
Intersecting Roads
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Mark on sketch
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Intersecting Road?
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Road Name
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Location
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Other assets / services
Proposed Treatment
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Treatment
- Final Seal
- Reseal
- GRS
- Microsurfacing
- DGA Overlay
- SMA Overlay
- 200mm remove and replace
- 35-50mm remove and replace
- HPWT
- Grinding
- Rehabilitation
- Other (including combination treatments)
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Other Treatment
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Stone size
- 5
- 7
- 10
- 14
- 20
- 14/7
- 20/7
- Other
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Other size
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Binder
- C170
- C320
- A10E
- HSS
- XSS
- SAM
- SAMI
- Other
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Other binder
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Full name of treatment
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Comments (including reasons for treatment selection, type of defects within site, etc)
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Suction Sweeper (N if shoulders are unsealed or asphalt treatment)
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2 attenuators (Y if on GV or Hume freeways)
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Pre-Treatment
- None
- Dry Top
- Pre-Spray
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Dry Top - Area (m2)
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Pre-spray
- Diff Line
- Centre Line
- Edge Line
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Area (m2)
Alternative Treatment
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Treatment
- Final Seal
- Reseal
- GRS
- Microsurfacing
- DGA Overlay
- SMA Overlay
- 200mm remove and replace
- 35-50mm remove and replace
- HPWT
- Grinding
- Rehabilitation
- Other (including combination treatments)
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Stone size
- 5
- 7
- 10
- 14
- 20
- 14/7
- 20/7
- Other
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Binder
- C170
- C320
- A10E
- HSS
- XSS
- SAM
- SAMI
- Other
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Full name of alternative treatment
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Comments (including reasons for alternative treatment selection)
Site Elements
- Elements
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Element
- L1 - Lane 1
- L2 - Lane 2
- PL - Passing Lane
- RS - Right Shoulder
- LS - Left Shoulder
- TS - Turn Slot
- LT - Left Turn
- RT - Right Turn
- B - Bell
- LWP - Left Wheel Path
- RWP - Right Wheel Path
- FW - Full Width
- CR - Centre of Road
- P - Path
- BWP - Between Wheel Path
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Start Location
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End Location
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Start KM
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End KM
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Length (m)
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Width (m)
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Depth (m)
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QTY
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UOM
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Comments
Preparation Works
- Preparation Works
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Preparation required
- Crack sealing
- Digouts
- Regulations
- Edge Repair
- Potholes
- Vegetation
- Drainage
- Other
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Extent
Site Considerations
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Risks
- Power lines
- Sight distance
- Traffic movements
- Pedestrians
- Out ofhours work
- Traffic queuing causing flushing / plucking
- None
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Other
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Comms Required
- Letter drop
- VMS
- Paper
- Shire
- Emergency Services
- Real Time
- None
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Comments
Stacksite
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Stacksite No.
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axim_ID
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Location
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Comments (including condition, size, etc)
Pavement Marking
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Line Marking replacement
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Paint (m)
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Long Life (m)
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Stripe (m)
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Semi (m)
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Double (m)
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Single (m)
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Edge 100 (m)
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Edge 150 (m)
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Tactile Edge (m)
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Tactile Stripe (m)
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Tactile Semi (m)
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Tactile Double (m)
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Centre L Black Tactile (m)
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Edge L Black Tactile (m)
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Continuity (m)
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Give Way (m)
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Stop (m)
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Arrows (No.)
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Chevrons (No.)
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RRPM W (No.)
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RRPM Y (No.)
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RRPM R (No.)
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RRPM G (No.)
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Other
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Tactile Replacement
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Edge Line Length (m)
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Centre Line length (m)
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Comments
Condition Data (desktop validation - not for completion onsite)
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RIPC Site
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axim_ID
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Ave. PCI
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Texture Depth
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% Cracking
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Roughness
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Rutting
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Deflection
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One-way AADT
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Two-way AADT
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EHV %
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Growth rate
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Year
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Posted Speed
Site Photos
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Add Images
Site Sketch
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Site Sketch
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Map Photo
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