Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Road Surface

  • Are potholes present?

  • Are the potholes significant enough to cause damage to the road or road users?

  • Can this be repaired internally?

  • Can this be reinstated with Cold-Mix bitumen?

  • Is Line Marking present in this road?

  • Is the line marking clear and visible?

  • Does the line marking need replacing?

  • Are RRPM’s required?

  • Add location


  • Does this road have kerbing?

  • Is the kerbing in good condition?

  • Can the kerb be repaired?

  • Does the kerb require replacing?

  • Is the damaged kerb a hazard to road users?

  • Can the kerb be removed?

  • Add location
  • Add media

Open Drains

  • Are open Drains present in this area

  • Are the clear of any debris or trash?

  • Are the Drains clear of excess vegetation?

  • Can the Drains be cleared internally?

  • Do the Drains need reshaping?

  • Add location
  • Add media

Closed (Under Ground Drains)

  • Are underground drains present?

  • Is a head wall present?

  • Is the drain concrete?

  • Is the drain HDPE?

  • Is the drain a pipe culvert?

  • Is the drain a box culvert?

  • Has the drain collapsed in any section?

  • Add media

  • Can the drain be repaired internally?

  • Add location

Street signs

  • Are street signs present?

  • Is the sign relevant?

  • Is the damaged?

  • Is the sign dirty?

  • Can the sign be repaired/cleaned?

  • Can the sign be removed?

  • Add media

  • Add location

Jetty & Boat ramps

  • Is the jetty/ramp damaged?

  • Is the jetty/tank dirty or graffitied?

  • Can the jetty/tamp be repaired?

  • Can the jetty/tamp be cleaned?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.