Scope Checklist

SITE DETAILS

• Street Name

• Work Type

  Select Footway Program Drainage Program PCTC Program Roads Program Bridge Repair Seawall Repair CWO Granite Infill Kerb and Gutter Program fence and stairs retaining structures other

  • Footway Program
  • Drainage Program
  • PCTC Program
  • Roads Program
  • Bridge Repair
  • Seawall Repair
  • CWO
  • Granite Infill
  • Kerb and Gutter Program
  • fence and stairs
  • retaining structures
  • other

• Give details

• Contract Coordinator

  Select A Christie R Henson R McColough I Shrestha B Blier F Sanai J Prasniscki M Baxter D Stamatelos G Mann W Keeley

  • A Christie
  • R Henson
  • R McColough
  • I Shrestha
  • B Blier
  • F Sanai
  • J Prasniscki
  • M Baxter
  • D Stamatelos
  • G Mann
  • W Keeley

• Service Provider

• Job Number

• Select date

  Date

DESIGN

• Does these works needs to be done?

  Yes

  No

  N/A

• Holds point identified?

  Yes

  No

  N/A

• Can the job be built as designed?

  Yes

  No

  N/A

• Design drawings approved for construction?

  Yes

  No

  N/A

• Any design actions?

SITE COORDINATION

• Bus routes and bus lane in the works area?

  Yes

  No

  N/A

• Traffic lights loops affected by the works?

  Yes

  No

  N/A

• Overhead wires in the works area?

  Yes

  No

  N/A

• DBYD conducted?

  Yes

  No

  N/A

• Plant drop off location to be identified?

  Yes

  No

  N/A

• Any CWO works in the area?

  Yes

  No

  N/A

• Before photos taken?

  Yes

  No

  N/A

• Any heritage issues identified?

  Yes

  No

  N/A

• Service pit lids adjustment required?

  Yes

  No

  N/A

• Risk Management Worksheet required?

  Yes

  No

  N/A

• ROL required?

  Yes

  No

  N/A

• Line marking survey required?

  Yes

  No

  N/A

• Night works required?

  Yes

  No

  N/A

• VMS required?

  Yes

  No

  N/A

• Dilapidation report required?

  Yes

  No

  N/A

• Tree pruning/roots required?

  Yes

  No

  N/A

• Car share affected?

  Yes

  No

  N/A

• Site Coordination Actions?

COMMUNITY

• Hotel, Major business affected?

  Yes

  No

  N/A

• School area near?

  Yes

  No

  N/A

• Police, Fire or Ambulance affected?

  Yes

  No

  N/A

• Notification letter required

  Yes

  No

  N/A

• 4 Weeks Notification

• 2 Weeks Notification

• 1 Week Notification

• Community Actions?

OTHER NOTES

AUTHORISATION

• City Representative

  Sign

• Service Provider Representative

  Sign