Title Page
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Date and Time of Inspection
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Client (Contractor) That Flagging Services Are Being Provided To
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Name of Person Completing Inspection
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Location
Checklist
GENERAL INFORMATION
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Project Name
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Roadway Speed Classification
- Low Speed (35 MPH or less)
- Intermediate Speed (Between 40-50 MPH)
- High Speed (55 MPH or greater)
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Posted Speed Limit
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Weather/Light Conditions
- Sunny
- Raining
- Snowing
- Foggy
- Dark
- Cloudy
- Partly cloudy with sun
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Traffic Conditions
HAZARD ASSESSMENT & DOCUMENTATION
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Hazard Assessment Completed Prior to Start of Work? (Tailgate Meeting)
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Did all employees print and sign the Hazard Assessment Document to indicate that they are aware of the hazards & controls associated with the work today?
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Photo of Hazard Assessment Documentation (JSA, JHA, THA, Toolbox Talk, etc..)
TEMPORARY TRAFFIC CONTROL
ADVANCE WARNING SIGNS
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Is the proper signage erected to warn drivers of what to expect? (Flagger ahead, be prepared to stop, one lane ahead, etc...)
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Is there an appropriate number of signs placed in accordance with the standard?
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Are all signs in good condition (clean, legible, and reflective)?
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Do all sign placements (height, visibility, and spacing) conform to standard regulation? (Refer to MUTCD Clipboard)
CHANNELIZING DEVICES
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Are all barricades in good condition?
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Are all drums in good condition?
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Are all safety cones in good condition?
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REFERENCE: Safety cones in good condition
[This is an example of how you can use iAuditor to include best practice reference images in your templates to assist with inspections] -
Are candy cane devices being used through the active work zone to heighten driver awareness?
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Are all vertical panels in good condition?
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Are all warning lights in good condition?
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Do all channelizing devices have appropriate battery mount?
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Do all channelizing devices have appropriate appropriate ballasting?
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Do all channelizing devices have adequate spacing?
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Do all channelizing devices have adequate taper length?
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Is the number of devices placed appropriately?
FLAGGING
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Are all flaggers trained/certified?
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Are flaggers alert and fit for duty?
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Are flagger's cell phones put away and not in use during flagging operations?
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Is there an escape route established for flaggers?
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Are flaggers standing in pinch or crush points (Between traffic & other objects)
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Are the flagger stations preceded by advance warning signs?
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Are flaggers clearly visible to approaching traffic?
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Are flaggers facing oncoming traffic at all times?
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Are the flagger stations illuminated? (Night time)
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Are flaggers using proper signaling devices? (Stop/Slow Paddles)
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Are there portable radios issued and being used by flaggers to communicate?
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Do flaggers have a way to communicate with the contractor on site?
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Are flaggers wearing high visibility class 3 vests?
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Are flaggers wearing additional required PPE? (Hard Hat, Safety Glasses, Safety Toe Boots)
ROADSIDE SAFETY
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Are all barriers in good condition?
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Are all barrier delineation lights in good condition?
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Are all barrier delineation reflectors in good condition?
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Is there an adequate drop-off delineation?
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Is there an adequate clear zone?
COMPLETION
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Coaching Opportunities (Issues & areas for improvement)
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Did you have a (Coaching) conversation with employees to resolve outstanding issues?
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Were all issues resolved?
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Name and Signature of Supervisor or Safety Rep. Completing Audit
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Name and Signature of Crew Leader
PHOTOS
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Photo 1
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Photo 2
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Photo 3
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Additional Photo
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Additional Photo