Information
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Document No.
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Road Name
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Conducted on
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Prepared by
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Location
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Testing conditions: Ensure testing is performed on dry, mainly horizontal surface with wind under 19km/hr
Road Surface Condition
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Enter number of different seal surfaces
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Road length
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Other Information
Seal Surface 1
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Photo of Seal Surface 1
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Enter Chainage (or physical description)
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Enter length
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Enter width
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Sand Patch Test 1 Location
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Sand Patch Test 1 Result
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Sand Patch Test 2 Location
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Sand Patch Test 2 Result
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Sand Patch Test 3 Location
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Sand Patch Test 3 Result
Seal Surface 2
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Photo of Seal Surface 2
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Enter Chainage (or physical description)
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Enter length
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Enter width
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Sand Patch Test 1 Location
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Sand Patch Test 1 Result
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Sand Patch Test 2 Location
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Sand Patch Test 2 Result
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Sand Patch Test 3 Location
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Sand Patch Test 3 Result
Seal Surface 3
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Photo of Seal Surface 3
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Enter Chainage (or physical description)
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Enter length
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Enter width
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Sand Patch Test 1 Location
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Sand Patch Test 1 Result
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Sand Patch Test 2 Location
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Sand Patch Test 2 Result
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Sand Patch Test 3 Location
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Sand Patch Test 3 Result
Seal Surface 4
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Photo of Seal Surface 4
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Enter Chainage (or physical description)
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Enter length
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Enter width
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Sand Patch Test 1 Location
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Sand Patch Test 1 Result
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Sand Patch Test 2 Location
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Sand Patch Test 2 Result
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Sand Patch Test 3 Location
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Sand Patch Test 3 Result
Seal Surface 5
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Photo of Seal Surface 5
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Enter Chainage (or physical description)
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Enter length
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Enter width
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Sand Patch Test 1 Location
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Sand Patch Test 1 Result
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Sand Patch Test 2 Location
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Sand Patch Test 2 Result
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Sand Patch Test 3 Location
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Sand Patch Test 3 Result
