ROAD REHABILITATION INSPECTION SHEET

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Road Identification

• Road Name

• Suburb

• Road Number

• Block Number

• Photo of Road

  Media

Rehab Details

• Area (from Geohub)

• Length (m)

• Width (m)

• Assumed Treatment

  Select Full Depth Asphalt Pavement (Deeplift) Insitu Stabilisation Granular Geo Grid Glass Grid Granular/Asphalt mix Concrete

  • Full Depth Asphalt Pavement (Deeplift)
  • Insitu Stabilisation
  • Granular
  • Geo Grid
  • Glass Grid
  • Granular/Asphalt mix
  • Concrete

• Preliminary Estimate

History

• History from maintenance Depot

• History Other

• History from PMS attached

  Yes

  No

  N/A

• Traffic Counts Attached

  Yes

  No

  N/A

• FWD Attached

  Yes

  No

  N/A

• Geotechnical Testing Report attached

  Yes

  No

  N/A

Existing Pavement Defects (Size and Type)

• Road Defect Locations

  Drawing

• Pavement Defect ID Number

  Media

• Pavement Defect 1 (type and area (m))

• Pavement Defect 2 (type and area (m))

• Pavement Defect 3 (type and area (m))

• Pavement Defect 4 (type and area (m))

• Pavement Defect 5 (type and area (m))

• Pavement Defect 6 (type and area (m))

• Pavement Defect 7 (type and area (m))

• Pavement Defect 8 (type and area (m))

• Pavement Defect 9 (type and area (m))

• Pavement Defect 10 (type and area (m))

Existing Defects (other than road)

• Type of Defect

  Media

• Visible Drainage Works Required

• Retaining Structures

• Footpaths/Kerb Ramps

• Other

Issues affecting Design

• Heavy Vehicle Route

  Yes

  No

  N/A

• Bus Route

  Yes

  No

  N/A

• Other 1

• Other 2

Construction

• Select date

  Date

• Issues Effecting Construction Date