Information
1. SITE LOCATION
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Road Name
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Suburb
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Ward Location
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Prepared by
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Conducted on
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Additional Personnel Conducting Assessment
SWEEPING
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Is road surface free of build up of debris
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Are traffic devices free of build up of debris
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Is the footpath free of build up of debris
PAVEMENT REPAIRS
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Is the road pavement free of potholes that require repair
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Is pavement free of any minor patching required
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Is the pavement free of any major patching required
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Is the pavement free of any crack sealing required
FOOTPATH REPAIRS
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Are footpaths free of trip hazards greater than 88mm
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Is the footpath free of sections that require replacement
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If footpath section requires replacement, what type of material is required
- Not Required
- Concrete
- Coloured Concrete
- Brick
- Asphelt
- Pepplecrete
KERB AND GUTTER
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Is kerb and gutter free of damage
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Is kerb and gutter free of water pooling
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Is kerb and gutter still in alignment
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If works are required, what style of kerb and gutter requires replacement
SHOULDER
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Is the shoulder free of edge break
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Is the shoulder in good condition and not requiring re sheeting
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Is the roadside vegetation sufficiently clear of shoulder
DRAINAGE
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Are culvert and pits clear
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Are open drains free of obstruction
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Are drainage lintels in good condition
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Are drainage head walls in good condition
ROAD ASSETS
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Do fences appear to be in sound condition
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Do hand rails appear to be good condition
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Are delineators appropriate
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Are ripple strips secure and in place
SIGNAGE
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Are street name signs in place
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Is signage unobstructed by vegetation
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Are signs free of graffiti
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Are warning and regulatory signs unobstructed
STREET FURNITURE
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Are seats in good condition
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Are shelter sheds in good condition
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Is street furniture free of graffiti.
ADDITIONAL INFOTMATION
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Is there any further information or comments required.
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Please photograph any further information required
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PLAESE SIGN ON COMPLETION OF INSPECTION