Reseal Inspection Sheet

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Block Description

• Road ID

• Block ID

• Extents of work (If different to block) or Other Comments on Road

Treatment

• Select Treatment Type

  Select Asphalt Overlay Chip Seal Rejuvenation Treatment Mill & Fill Rehab Required No Treatment Required

  • Asphalt Overlay
  • Chip Seal
  • Rejuvenation Treatment
  • Mill & Fill
  • Rehab Required
  • No Treatment Required

• Asphalt Type

  DG14

  BCC10

  NA

• Rejuvenation Treatment

  Heavy Duty (Liquid Road)

  Medium Duty (Master Seal)

  Light (Aspen AC)

  NA

• Chip Seal Sand Patch Test #1

• Chip Seal Sand Patch Test #2

• Chip Seal Sand Patch Test #3

• Chip Seal Sand Patch Test #4

• Chip Seal Sand Patch Test #5

Measurements

• Length of Road (m)

• Width of Road (m)

• Variable Width (Cul-de-sac, Turn Out, Parking Lane, etc)

  Yes

  No

  N/A

• Edge Plane (m)

Driveways

• Enter House Number(s)

• Photo of Problem Driveway(s)

  Media

Road Sketch

• Sketch Road and Defect Locations (Pavement, Drainage, Other, Etc)

  Drawing

• Sketch Road and Defect Locations (Pavement, Drainage, Other, Etc)

  Drawing

• Sketch Road and Defect Locations (Pavement, Drainage, Other, Etc)

  Drawing

• Photo of sketch of Road and Defect Locations

  Media

Works Required (non pavement failure)

• Arborist Required

  Yes

  No

  N/A

• Weed Spraying Required

  Yes

  No

  N/A

• Traffic Calming Device (Only if removal is required for treatment)

  Yes

  No

  N/A

• Special Line Marking (Yellow Lines, Green Bicycle Lanes, Bicycle Symbols, etc)

  Yes

  No

  N/A

• Shoulder Work

• Traffic Light Loops (Number)

• Service Lids to be Raised (number)

Drainage Works 1

• Type of Drainage Works Required

  Select K&C Grate Lintel & Grate Lintel, Grate & Pit Table Drains Other

  • K&C
  • Grate
  • Lintel & Grate
  • Lintel, Grate & Pit
  • Table Drains
  • Other

• Length (m) or Description of Other

• Photo of Drainage Works

  Media

Drainage Works 2

• Type of Drainage Works Required

  Select K&C Grate Lintel & Grate Lintel, Grate & Pit Table Drains Other

  • K&C
  • Grate
  • Lintel & Grate
  • Lintel, Grate & Pit
  • Table Drains
  • Other

• Length (m) or Description of Other

• Photo of Drainage Works

  Media

Drainage Works 3

• Type of Drainage Works Required

  Select K&C Grate Lintel & Grate Lintel, Grate & Pit Table Drains Other

  • K&C
  • Grate
  • Lintel & Grate
  • Lintel, Grate & Pit
  • Table Drains
  • Other

• Length (m) or Description of Other

• Photo of Drainage Works

  Media

Drainage Works 4

• Type of Drainage Works Required

  Select K&C Grate Lintel & Grate Lintel, Grate & Pit Table Drains Other

  • K&C
  • Grate
  • Lintel & Grate
  • Lintel, Grate & Pit
  • Table Drains
  • Other

• Length (m) or Description of Other

• Photo of Drainage Works

  Media

Road Failures 1

• Type of Failure

  Select Crocodile Cracking Block Cracking Delamination Ravelling\Stripping Patch failure Isolated Depressions Rutting Shoving Edge Failure Pavement Pumping

  • Crocodile Cracking
  • Block Cracking
  • Delamination
  • Ravelling\Stripping
  • Patch failure
  • Isolated Depressions
  • Rutting
  • Shoving
  • Edge Failure
  • Pavement Pumping

• Area (m2)

• Photo of Failure

  Media

Road Failures 2

• Type of Failure

  Select Crocodile Cracking Block Cracking Delamination Ravelling\Stripping Patch failure Isolated Depressions Rutting Shoving Edge Failure Pavement Pumping

  • Crocodile Cracking
  • Block Cracking
  • Delamination
  • Ravelling\Stripping
  • Patch failure
  • Isolated Depressions
  • Rutting
  • Shoving
  • Edge Failure
  • Pavement Pumping

• Area (m2)

• Photo of Failure

  Media

Road Failures 3

• Type of Failure

  Select Crocodile Cracking Block Cracking Delamination Ravelling\Stripping Patch failure Isolated Depressions Rutting Shoving Edge Failure Pavement Pumping

  • Crocodile Cracking
  • Block Cracking
  • Delamination
  • Ravelling\Stripping
  • Patch failure
  • Isolated Depressions
  • Rutting
  • Shoving
  • Edge Failure
  • Pavement Pumping

• Area (m2)

• Photo of Failure

  Media

Road Failures 4

• Type of Failure

  Select Crocodile Cracking Block Cracking Delamination Ravelling\Stripping Patch failure Isolated Depressions Rutting Shoving Edge Failure Pavement Pumping

  • Crocodile Cracking
  • Block Cracking
  • Delamination
  • Ravelling\Stripping
  • Patch failure
  • Isolated Depressions
  • Rutting
  • Shoving
  • Edge Failure
  • Pavement Pumping

• Area (m2)

• Photo of Failure

  Media

Road Failures 5

• Type of Failure

  Select Crocodile Cracking Block Cracking Delamination Ravelling\Stripping Patch failure Isolated Depressions Rutting Shoving Edge Failure Pavement Pumping

  • Crocodile Cracking
  • Block Cracking
  • Delamination
  • Ravelling\Stripping
  • Patch failure
  • Isolated Depressions
  • Rutting
  • Shoving
  • Edge Failure
  • Pavement Pumping

• Area (m2)

• Photo of Failure

  Media

Road Failures 6

• Type of Failure

  Select Crocodile Cracking Block Cracking Delamination Ravelling\Stripping Patch failure Isolated Depressions Rutting Shoving Edge Failure Pavement Pumping

  • Crocodile Cracking
  • Block Cracking
  • Delamination
  • Ravelling\Stripping
  • Patch failure
  • Isolated Depressions
  • Rutting
  • Shoving
  • Edge Failure
  • Pavement Pumping

• Area (m2)

• Photo of Failure

  Media

Road Failures 7

• Type of Failure

  Select Crocodile Cracking Block Cracking Delamination Ravelling\Stripping Patch failure Isolated Depressions Rutting Shoving Edge Failure Pavement Pumping

  • Crocodile Cracking
  • Block Cracking
  • Delamination
  • Ravelling\Stripping
  • Patch failure
  • Isolated Depressions
  • Rutting
  • Shoving
  • Edge Failure
  • Pavement Pumping

• Area (m2)

• Photo of Failure

  Media

Road Failures 8

• Type of Failure

  Select Crocodile Cracking Block Cracking Delamination Ravelling\Stripping Patch failure Isolated Depressions Rutting Shoving Edge Failure Pavement Pumping

  • Crocodile Cracking
  • Block Cracking
  • Delamination
  • Ravelling\Stripping
  • Patch failure
  • Isolated Depressions
  • Rutting
  • Shoving
  • Edge Failure
  • Pavement Pumping

• Area (m2)

• Photo of Failure

  Media

Road Failures 9

• Type of Failure

  Select Crocodile Cracking Block Cracking Delamination Ravelling\Stripping Patch failure Isolated Depressions Rutting Shoving Edge Failure Pavement Pumping

  • Crocodile Cracking
  • Block Cracking
  • Delamination
  • Ravelling\Stripping
  • Patch failure
  • Isolated Depressions
  • Rutting
  • Shoving
  • Edge Failure
  • Pavement Pumping

• Area (m2)

• Photo of Failure

  Media

Road Failures 10

• Type of Failure

  Select Crocodile Cracking Block Cracking Delamination Ravelling\Stripping Patch failure Isolated Depressions Rutting Shoving Edge Failure Pavement Pumping

  • Crocodile Cracking
  • Block Cracking
  • Delamination
  • Ravelling\Stripping
  • Patch failure
  • Isolated Depressions
  • Rutting
  • Shoving
  • Edge Failure
  • Pavement Pumping

• Area (m2)

• Photo of Failure

  Media

Road Failures 11

• Type of Failure

  Select Crocodile Cracking Block Cracking Delamination Ravelling\Stripping Patch failure Isolated Depressions Rutting Shoving Edge Failure Pavement Pumping

  • Crocodile Cracking
  • Block Cracking
  • Delamination
  • Ravelling\Stripping
  • Patch failure
  • Isolated Depressions
  • Rutting
  • Shoving
  • Edge Failure
  • Pavement Pumping

• Area (m2)

• Photo of Failure

  Media