Surveillance Checklist (Asphalt Contractors)

• Document No.

• Checklist Title

• Council / RMD Direct Delivery

• Sub-Contractor

• Conducted on

  Date

• Prepared by

• Location
  Address

Contractors Managements Documentation

• Relevant Quality Documentation have been reviewed or available and used onsite?

  Yes

  No

  N/A

• Project Induction completed for all site. Personnel?

  Yes

  No

  N/A

• Pre-Start Check-list completed for all Plant & Equipment ?

  Yes

  No

  N/A

• Tool Box Talk and Site Specific Risk Assessment completed?

  Yes

  No

  N/A

• Is Scope of Works correct and marked out?

  Yes

  No

  N/A

Traffic Control

• Traffic Control at Worksites 'Location Risk Assessment' Completed before starting work

  Yes

  No

  N/A

• TCP set up per approved plan, including night shift requirements?

  Yes

  No

  N/A

• Vehicle Movement Plan approved and fit for site use?

  Yes

  No

  N/A

• Traffic management plan approved and fit for site use?

  Yes

  No

  N/A

• Are there provisions for Pedestrians to travel through the worksite safely?

  Yes

  No

  N/A

Profiling

• Depth of cut is correct and verified?

  Yes

  No

  N/A

• Clean up and inspection of milled surface satisfactory?

  Yes

  No

  N/A

• Was there any Unsuitable identified?

  Yes

  No

  N/A

• Disposal of milled material to an approved site?

  Yes

  No

  N/A

• Weather and pavement conditions acceptable?

  Yes

  No

  N/A

Asphalt Placement and Compaction

• Is surface preparation completed and satisfactory?

  Yes

  No

  N/A

• Asphalt paving plan acceptable for site conditions?

  Yes

  No

  N/A

• Tack Coat application rate correct?

  Yes

  No

  N/A

• Truck Marshalling area established? (If required)

  Yes

  No

  N/A

• Reversing of vehicles on site. Is there a Spotter/Tip Man in place?

  Yes

  No

  N/A

• Asphalt mix type and temperature within specified limits?

  Yes

  No

  N/A

• Asphalt mix visually homogeneous?

  Yes

  No

  N/A

• Asphalt Traceability Record being completed?

  Yes

  No

  N/A

• Is the un-compacted layer thickness acceptable?

  Yes

  No

  N/A

• Compacted layer thickness as nominated?

  Yes

  No

  N/A

• Are all joints acceptable?

  Yes

  No

  N/A

• Rolling pattern acceptable?

  Yes

  No

  N/A

Finished Pavement Properties

• finished pavement texture acceptable?

  Yes

  No

  N/A

• Finished surface shape acceptable?

  Yes

  No

  N/A

• Ride quality acceptable?

  Yes

  No

  N/A

• Site clean up acceptable?

  Yes

  No

  N/A

• Plant and equipment parked in a safe and environmentally acceptable location?

  Yes

  No

  N/A

• Traffic control devices removed?

  Yes

  No

  N/A

• Surveillance Officer Notes

• Surveillance Officer Signature

  Sign

• Comments follow up ( Project / Contract Manager)