SITE AUDIT CHECKLIST

SIte Audit Checklist

• Conducted on

  Date

• Lack Group T/a K&D Traffic Management Pty Ltd Supervisor:

• Site Supervisor or Client Contact:-

• Client:-

• Project:

• TCP No.

• Location:
  Address

• Duration of work.

  Short Term

  Long Term

• Road Configuration:

SECTION 1 - WORKPLACE HEALTH & SAFETY (WH&S)

• Rate in the following manner: Yes (conforms) No (non conformance) or Not Applicable (N/A)

Part 1. Traffic Control Plan (TCP)

• 1.1 Does the work require a:-

• A Traffic Management Plan (TMP)?

  Yes

  No

  N/A

• A Traffic Control Plan (TCP)?

  Yes

  No

  N/A

• A Vehicle Control Plan (VMP)?

  Yes

  No

  N/A

• A Pedestrian Management Plan (PMP)?

  Yes

  No

  N/A

• 1.2 Are all required plans approved?

  Yes

  No

  N/A

• 1.3 Is the approved TCP on site?

  Yes

  No

  N/A

• 1.4 Have signs and devices been set up as in the TCP?

  Yes

  No

  N/A

• 1.5 If modifications been made, are they approved and marked on the plan by an appropriately ticketed person. (Transport and Main Roads [TMR] 3 Traffic Management)?

  Yes

  No

  N/A

• 1.6 Has a Site Specific Risk Assessment (SSRA) been done?

  Yes

  No

  N/A

• 1.7. Is the TCP relevant for the works in progress?

  Yes

  No

  N/A

• 1.8. Has a permit been issued by Local Council or Department of Transport and Main Roads (TMR) and is it being complied <br> with?

  Yes

  No

  N/A

• 1.9. Is the permit held onsite?

  Yes

  No

  N/A

• 1.11 Are the requirements implemented for safe clearances to workers and pedestrians and traffic approach speeds?<br>

  Yes

  No

  N/A

• Additional draw plans by inspecting person.

  Drawing

• ALL NON CONFORMANCES AND CORRECTIVE ACTIONS ARE TO BE NOTED ON SEPARATE "NON CONFORMANCE-CORRECTIVE ACTION-PREVENTIVE ACTION REPORT" [IMS-FM-SAF-013-RO. Revision Date: 28.06.12]

Part 2. Roadwork Speed Zones (RSZ)

• 2.1 Are records being kept regarding the times of the signage installation?

  Yes

  No

  N/A

• 2.2 Where a Speed Zone is in place, is the limit appropriate for the work being undertaken? TCWS section 8.2.3

  Yes

  No

  N/A

• 2.3 Is the speed limit/s operating within the approved times listed on the permit?

  Yes

  No

  N/A

• 2.4 Is the length of the speed zone as per the Manual of Uniform Traffic Control Devices (MUTCD) - part 3 Works on Roads?

  Yes

  No

  N/A

• 2.5 Are Advanced Speed Warning Signs used appropriately?

  Yes

  No

  N/A

• 2.6 Are speed signs duplicated at the start of the speed zone? This is dependent on the SSRA.

  Yes

  No

  N/A

• 2.7 Are speed signs the correct size?

  Yes

  No

  N/A

• 2.8 Are all signs installed at the correct spacing?

  Yes

  No

  N/A

• 2.9 Are all signs installed at the correct height?

  Yes

  No

  N/A

• 2.10 Have fixed speed signs and pavement markings been covered/removed?

  Yes

  No

  N/A

• 2.11 Are repeater signs installed if required?

  Yes

  No

  N/A

• 2.16 At the end of the work, has has the fixed speed limit been reinstated?

  Yes

  No

  N/A

• 2.13 Are signs covered adequately when not in use?

  Yes

  No

  N/A

• 2.14 Other comments.

  Yes

  No

  N/A

• ALL NON CONFORMANCES AND CORRECTIVE ACTIONS ARE TO BE NOTED ON SEPARATE "NON CONFORMANCE-CORRECTIVE ACTION-PREVENTIVE ACTION REPORT" [IMS-FM-SAF-013-RO. Revision Date: 28.06.12]

Part 3. Record Keeping (Pre-starts, Site Specific Risk Assessments etc)

• 3.1 Are records being kept for roadwork speed zones?

  Yes

  No

  N/A

• 3.2 Is there a completed SWMS signed by employees on site?

  Yes

  No

  N/A

• 3.3 Is it the correct version?

  Yes

  No

  N/A

• 3.4 Has the Site Specific Risk Assessment been completed?

  Yes

  No

  N/A

• 3.5 Is there a completed signage check?

  Yes

  No

  N/A

• 3.6. Does the TC Supervisor have blank incident report forms?

  Yes

  No

  N/A

• 3.7 Other comments.

  Yes

  No

  N/A

• ALL NON CONFORMANCES AND CORRECTIVE ACTIONS ARE TO BE NOTED ON SEPARATE "NON CONFORMANCE-CORRECTIVE ACTION-PREVENTIVE ACTION REPORT" [IMS-FM-SAF-013-RO. Revision Date: 28.06.12]

Part 4. Traffic Controllers (TC's)

• 4.1 Are Traffic Controllers (TC's) being used?

  Yes

  No

  N/A

• 4.2 Are the correct number of TC'S being used?

  Yes

  No

  N/A

• 4.3 Have TC certificates been sighted and the numbers and expiry date recorded

  Yes

  No

  N/A

• 4.3A. General Construction Card<br> <br>

  Yes

  No

  N/A

• 4.3B. Traffic Controller Accreditation Cards?

  Yes

  No

  N/A

• 4.3C. Level 2 Traffic Management Card?

  Yes

  No

  N/A

• 4.4 Is TC's hi-viz clothing in good repair?

  Yes

  No

  N/A

• 4.5 Are all TC's wearing the correct PPE?

  Yes

  No

  N/A

• 4.6 Is the traffic speed restricted to a max of 60km/h?

  Yes

  No

  N/A

• 4.7 Is the sight distance to approaching traffic D or greater, as per the plan?

  Yes

  No

  N/A

• 4.8 Do TC's have a clear escape route?

  Yes

  No

  N/A

• 4.9. Are TC's able to communicate with each other (line of sight, two way radios, additional TC's)?

  Yes

  No

  N/A

• 4.10 Are the 'Prepare to Stop' and 'Traffic Controller Ahead', signs correctly displayed?<br>

  Yes

  No

  N/A

• 4.11. Are the above signs covered or removed when not required?

  Yes

  No

  N/A

• 4.12. Are they controlling traffic in accordance with Traffic Controller Accreditation Scheme - Approved Procedure (TCASAP)?

  Yes

  No

  N/A

• 4.13. If TC's are being used for night work:-

  Yes

  No

  N/A

• a. Are they wearing approved clothing?

  Yes

  No

  N/A

• b. Are they safely lit and visible?

  Yes

  No

  N/A

• c. Do they have correct communication?

  Safe

  At Risk

  N/A

• d. Are they using lighted wands?

  Yes

  No

  N/A

• 4.14. If the work is conducted at night are all requirements being met?

  Yes

  No

  N/A

• 4.15. For intermittent work are all requirements met?

  Yes

  No

  N/A

• 4.16. Other comments

  Safe

  At Risk

  N/A

• ALL NON CONFORMANCES AND CORRECTIVE ACTIONS ARE TO BE NOTED ON SEPARATE "NON CONFORMANCE-CORRECTIVE ACTION-PREVENTIVE ACTION REPORT" [IMS-FM-SAF-013-RO. Revision Date: 28.06.12]

Part 5: Portable Traffic Signals (PTS)

• ARE PORTABLE TRAFFIC LIGHTS BEING USED?<br>(If "NO" then go to Section 6)

  Applicable

  Not Applicable

• 5.1 Are PTS being used?

  Yes

  No

  N/A

• 5.2 Where PTS are being used, are they being used as per the issued permit?

  Yes

  No

  N/A

• 5.3 Are the PTS being used marked as complying with TMR specifications? <br><br><br><br><br><br>

  Yes

  No

  N/A

• 5.4 Are the PTS correctly registered?

  Yes

  No

  N/A

• 5.5 Is the approach speed of traffic reduced to 60km/h or less?

  Yes

  No

  N/A

• 5.6 Is minimum sight distance of 150 m provided?

  Yes

  No

  N/A

• 5.7 Are the PTS correctly sighted and established?

  Yes

  No

  N/A

• 5.8 Has a Holding Line been marked on the roadway?

  Yes

  No

  N/A

• 5.9 Are procedures in place to review the end- of-queue when PTS are operating?

  Yes

  No

  N/A

• 5.10 Have all signs associated with PTS been erected correctly?

  Yes

  No

  N/A

• 5.11 Other comments:-

  Yes

  No

  N/A

• ALL NON CONFORMANCES AND CORRECTIVE ACTIONS ARE TO BE NOTED ON SEPARATE "NON CONFORMANCE-CORRECTIVE ACTION-PREVENTIVE ACTION REPORT" [IMS-FM-SAF-013-RO. Revision Date: 28.06.12]

Part 6. Flashing Arrow Sign (FAS)

• ARE FLASHING ARROW SIGN BEING USED?<br>(If "NO" then go to Section 7)

  Applicable

  Not Applicable

• 6.1 Is a FAS being used?

  Yes

  No

  N/A

• 6.2 Is the FAS being used Marked as complying with MUTCD Specifications?

  Yes

  No

  N/A

• 6.3 Is it located correctly?

  Yes

  No

  N/A

• 6.4 Is it the correct size sign?

  Yes

  No

  N/A

• 6.5 Is the correct Mode of Operation being used?

  Yes

  No

  N/A

• 6.6 If lane status signs are being used in conjunction with FAS, is the message to the motorist the same?

  Yes

  No

  N/A

• 6.7 Other comments:

  Yes

  No

  N/A

• ALL NON CONFORMANCES AND CORRECTIVE ACTIONS ARE TO BE NOTED ON SEPARATE "NON CONFORMANCE-CORRECTIVE ACTION-PREVENTIVE ACTION REPORT" [IMS-FM-SAF-013-RO. Revision Date: 28.06.12]

Part 7. Variable Message Sign. (VMS)

• IS VARIABLE MESSAGE SIGN (VMS) BEING USED?<br>(If "NO" then go to Section 8)

  Applicable

  Not Applicable

• 7.1 Is a variable message sign being used as specified in MUTCD?

  Yes

  No

  N/A

• 7.2 Is the message relative to the works being undertaken?

  Yes

  No

  N/A

• 7.3 Are there less than four (4) words per screen and no more that two (2) screens on display?

  Yes

  No

  N/A

• 7.4 Is the sign located in a safe position?

  Yes

  No

  N/A

• 7.5. Other comments:

  Yes

  No

  N/A

• ALL NON CONFORMANCES AND CORRECTIVE ACTIONS ARE TO BE NOTED ON SEPARATE "NON CONFORMANCE-CORRECTIVE ACTION-PREVENTIVE ACTION REPORT" [IMS-FM-SAF-013-RO. Revision Date: 28.06.12]

Part 8. Safety Barriers

• ARE SAFETY BARRIERS BEING USED?<br>

  Applicable

  Not Applicable

• 8.1 Are safety barriers installed correctly?

  Yes

  No

  N/A

• 8.2 Have the correct barriers been installed?

  Yes

  No

  N/A

• 8.3 Where barrier sections are used as safety Safety Barriers, are they in compliance with speed zone?

  Yes

  No

  N/A

• 8.4 Where non rigid barriers are used as safety barriers, is work behind the barriers outside the 1.5 metre deflection zone?

  Yes

  No

  N/A

• 8.5 Are water filled safety barrier elements full of water and NO leaks evident?

  Yes

  No

  N/A

• 8.6 Is the safety barrier erected as designed?

  Yes

  No

  N/A

• 8.7 Has the approach speed of traffic been reduced to the barrier design rating?

  Yes

  No

  N/A

• 8.8 Other comments:

  Yes

  No

  N/A

• ALL NON CONFORMANCES AND CORRECTIVE ACTIONS ARE TO BE NOTED ON SEPARATE "NON CONFORMANCE-CORRECTIVE ACTION-PREVENTIVE ACTION REPORT" [IMS-FM-SAF-013-RO. Revision Date: 28.06.12]

Part 9. Signs and Devices

• 9.1 Are all signs and devices in good condition?

  Yes

  No

  N/A

• 9.2 Are the signs clearly visible and not affected by other signs, plant items, vegetation, shade, light glare etc?

  Yes

  No

  N/A

• 9.3 Are sign faces in compliance with The MUTCD and have Class 1W retro reflective sheeting?

  Yes

  No

  N/A

• 9.4 Are the correct sign sizes being used?

  Yes

  No

  N/A

• 9.5 Are signs duplicated, where required?

  Yes

  No

  N/A

• 9.6 Are signs erected at the correct height and position?

  Yes

  No

  N/A

• 9.7 Are the signs erected to give the correct sight distance?

  Yes

  No

  N/A

• 9.8 Are delineators facing with the flow of traffic?

  Yes

  No

  N/A

• 9.9 Are there any conflicting signs, devices or markings?

  Yes

  No

  N/A

• 9.10. Have the needs of pedestrians been provided for?

  Yes

  No

  N/A

• 9.11 Have the needs of cyclists been provided for?

  Yes

  No

  N/A

• 9.12. Are all properties accesses (residential & business) to the site controlled?

  Yes

  No

  N/A

• 9.13. Are all cones and bollards installed at the correct spacing?

  Yes

  No

  N/A

• 9.14. Ae the correct sized cones and bollards being used?

  Yes

  No

  N/A

• 9.15. Where tapers are used, have they been identified as 'Lateral Shift' or 'Merge' tapers?

  Yes

  No

  N/A

• Are the tapers the correct length?

  Yes

  No

  N/A

• 9.17 Where there are three (3) lanes of traffic or more in one direction, and two lanes are closed, are the separate merge tapers of the correct length?<br>

  Yes

  No

  N/A

• 9.17. Are the tapers separated by at least D or 2D?

  Yes

  No

  N/A

• 9.18. Where work is beyond a crest, curve or intersection, has the taper been set up before the crest, curve or intersection to allow for the safe approach of vehicles through the worksite?

  Yes

  No

  N/A

• 9.19. Are temporary walkways a minimum of 1.2 metres with wheelchair access?

  Yes

  No

  N/A

• 9.20. Other comments:

  Yes

  No

  N/A

• Additional draw plans by inspecting person.

  Drawing

• ALL NON CONFORMANCES AND CORRECTIVE ACTIONS ARE TO BE NOTED ON SEPARATE "NON CONFORMANCE-CORRECTIVE ACTION-PREVENTIVE ACTION REPORT" [IMS-FM-SAF-013-RO. Revision Date: 28.06.12]

Part 10 End-Of-Queue

• 10.1. Has an assessment of expected queue length been undertaken/documented?

  Yes

  No

  N/A

• 10.2. Has protection been provided where the end-of-queue is likely to be within'D' of the first downstream PTS sign?

  Yes

  No

  N/A

• 10.3. Is a sight distance between approaching motorists and the end-of-queue, being maintained at greater than '2D' (open road areas) and '1.5D' (built up areas)?

  Yes

  No

  N/A

• 10.4 Where the first PTS sign is more than '4D' from the control point, are 'Repeater Signs' placed at intervals of NOT more than '4D'?

  Yes

  No

  N/A

• 10.5. Is the traffic queue monitored at all times during the course of the work?

  Yes

  No

  N/A

• 10.6. Other Comments:-

  Yes

  No

  N/A

• ALL NON CONFORMANCES AND CORRECTIVE ACTIONS ARE TO BE NOTED ON SEPARATE "NON CONFORMANCE-CORRECTIVE ACTION-PREVENTIVE ACTION REPORT" [IMS-FM-SAF-013-RO. Revision Date: 28.06.12]

Part 11. Workers on Foot Near Plant

• 11.1 Have workers working within 3 meters of plant, been trained/briefed/tool-boxed as per the Lack Group, Traffic Management, Safe Work Method Statement?

  Yes

  No

  N/A

• 11.2 Where workers are working close to revolving plant, are satisfactory risk controls in place?

  Yes

  No

  N/A

• 11.3. Are spotters being used near reversing plant or delivery vehicles?

  Yes

  No

  N/A

• 11.4. Where a spotter is used, are all requirements being used?

  Yes

  No

  N/A

• 11.5 Where travelling plant or vehicles travel slower than 20Km/h below the normal road speed limit, do they comply with the requirements of the MUTCD?

  Yes

  No

  N/A

• 11.6. For mobile work, are all requirements being met?

  Yes

  No

  N/A

• 11.7. Other Comments:-

  Yes

  No

  N/A

• ALL NON CONFORMANCES AND CORRECTIVE ACTIONS ARE TO BE NOTED ON SEPARATE "NON CONFORMANCE-CORRECTIVE ACTION-PREVENTIVE ACTION REPORT" [IMS-FM-SAF-013-RO. Revision Date: 28.06.12]

• Additional draw plans by inspecting person.

  Drawing

• Lack Group t/as K&D Traffic Management Pty Ltd Supervisor.

  Sign

• Site Supervisor or Authorized Representative.

  Sign

SECTION 2 - ENVIRONMENTAL COMPLIANCE MONITORING

• Rate in the following manner: Yes (safe) No (at risk) [non conformance] or Not Applicable (N/A)

• ON SITE ENVIRONMENTAL CONTROLS MUST NOT BE INTERFERED WITH DURING INSTALLATION AND REMOVAL OF TRAFFIC GUIDANCE SCHEMES OR DURING GENERAL COMMUTING THROUGHOUT THE WORK SITE.
  HAVE THE FOLLOWING CONTROLS BEEN AFFECTED BY LACK GROUP t/as K&D TRAFFIC MANAGEMENT PTY LTD OPERATIONS?
  IF SO! HAVE THEY BEEN REPORTED TO THE ONSITE &/OR LACK GROUP WHS&E MANAGER.

Part 12. ENVIRONMENTAL CONTROL

• 12.1 Pavement and road surfaces are free of spoil and other eroding materials?<br> (traffic control vehicle movements from road shoulder to road pavement surface)

  Yes

  No

  N/A

• 12.2. Plant/equipment (including truck tyres & plant tracks) cleaned before leaving site?

  Yes

  No

  N/A

• 12.3 Are plant and equipment movements on surfaces that are susceptible to erosion, limited?

  Yes

  No

  N/A

WATER CONTROL AND GROUND WATER

• 12.4 Is plant & equipment inspected for leaks of fuel, oil or hydraulic fluid? ( The vehicle checklist is in the Traffic Controllers

  Yes

  No

  N/A

• 12.5. Is there any evidence of waste disposal to storm water, sewer, drainage lines, water courses and/or water bodies?

  Yes

  No

  N/A

AIR QUALITY (OBJECTIVE: to avoid dust and/or odour complaints)

• 12.6. Are areas adjacent to worksite free of soil and dust?

  Yes

  No

  N/A

• 12.7. Are plant and equipment movements limited on surfaces susceptible to dust generation?

  Yes

  No

  N/A

• 12.8. Are loads covered and secured prior to leaving site?

  Yes

  No

  N/A

• 12.9. Site swept clean prior to leaving?

  Yes

  No

  N/A

WASTE MANAGEMENT (OBJECTIVE: to reduce waste generation and ensure the safe and responsible disposal of waste)

• 12.10. Is the worksite free of litter?

  Yes

  No

  N/A

• 12.11. Is all litter taken away at the end of the shift and placed in the relevant waste receptacles?

  Yes

  No

  N/A

NOISE and VIBRATION. (OBJECTIVE: to avoid noise and/or vibration complaints)

• 12.12. Are plant and/or equipment engines are enclosed and mufflers are in place on traffic control vehicles, lighting towers?

  Yes

  No

  N/A

• 12.13. Is any work taking place on Sundays or Public Holidays? ( out of hours work permitted as per clients permit)

  Yes

  No

  N/A

• 12.14 No noisy works, deliveries or communications outside allowable times. (as per clients permit)

  Yes

  No

  N/A

BIODIVERSITY

• 12.15 No equipment or materials is placed on native vegetation outside worksites or within drip lines of trees.

  Yes

  No

  N/A

ENERGY and GREENHOUSE (OBJECTIVE: to maximise the efficient use of energy and resources)

• 12.16. Is plant and equipment well maintained?

  Yes

  No

  N/A

• 12.17. Is plant and equipment not left idling when not in use?

  Yes

  No

  N/A

HERITAGE (OBJECTIVE: to minimise community and environmental impacts during delivery)

• 12.19. Ensure no disturbance or damage to heritage items.

  Yes

  No

  N/A

SITE RESTORATION (OBJECTIVE: to minimise community and environmental impact during delivery)

• 12.20. Any evidence of structural damage to adjacent property/properties that is/are attributable to Lack Group t/as K&D Traffic Management Pty Ltd traffic control work?

  Yes

  No

  N/A

• ALL NON CONFORMANCES AND CORRECTIVE ACTIONS ARE TO BE NOTED ON SEPARATE "NON CONFORMANCE-CORRECTIVE ACTION-PREVENTIVE ACTION REPORT" [IMS-FM-SAF-013-RO. Revision Date: 28.06.12]

• Lack Group t/as K&D Traffic Management Pty Ltd Supervisor:

  Sign

• Site Supervisor:

  Sign

• Document Reference: IMS-FM-SAF-038-R0 Revision Date: 15.03.2013

• ABN: 43 123 149 539.

• "Uncontrolled document when printed"