Pre Condition Road Assessment

• Client / Site

• Conducted on

  Date

• Prepared by

• Document No.

• Personnel

• Location
  Address

• Road to be assessed

Road

• Road name

• Width?

• Shoulder width?

• Street furniture

  Yes

  No

• Type of street furniture?

  Select - Stop sign. - Give way sign. - Guide posts. - Street name sign. - Other directional sign.

  • - Stop sign.
  • - Give way sign.
  • - Guide posts.
  • - Street name sign.
  • - Other directional sign.

• Take photo

  Media

• Overhead power lines crossing the road

  Yes

  No

• NOTE: Ergonomic must be contacted for input and assessment

• Chainage location?

• Take photo

  Media

• Comments

• Traffic lights?

  Yes

  No

• Take photo

  Media

• Comments

• Street lights?

  Yes

  No

• Sufficient height to allow movement?

  Yes

  No

• Take photo

  Media

• Comments

Signoff

• Officers name

  Sign