Title Page

  • Date and Time of Inspection

  • Client (Contractor) That Flagging Services Are Being Provided To

  • Name of Person Completing Inspection

  • Location

Checklist

GENERAL INFORMATION

  • Project Name

  • Roadway Speed Classification

  • Posted Speed Limit

  • Weather/Light Conditions

  • Traffic Conditions

HAZARD ASSESSMENT & DOCUMENTATION

  • Hazard Assessment Completed Prior to Start of Work? (Tailgate Meeting)

  • 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?

  • Photo of Hazard Assessment Documentation (JSA, JHA, THA, Toolbox Talk, etc..)

TEMPORARY TRAFFIC CONTROL

ADVANCE WARNING SIGNS

  • REFERENCE: MUTCD Work Zone Safety Clipboard)

  • Is the proper signage erected to warn drivers of what to expect? (Flagger ahead, be prepared to stop, one lane ahead, etc...)

  • Is there an appropriate number of signs placed in accordance with the standard?

  • Are all signs in good condition (clean, legible, and reflective)?

  • Do all sign placements (height, visibility, and spacing) conform to standard regulation? (Reference Below or us MUTCD Clipboard)

  • REFERENCE: Advanced Warning Sign Spacing

    Advanced Warning Signs_Spacing.JPG
  • REFERENCE: MUTCD Work Zone Clipboard

    MUTCD Work Zone Clipboard.JPG

CHANNELIZING DEVICES

  • Are all barricades in good condition?

  • Are all drums in good condition?

  • Are all safety cones in good condition?

  • REFERENCE: Safety cones in good condition

    safety cones ref.jpg
  • Are candy cane devices being used through the active work zone to heighten driver awareness boundaries?

  • REFERENCE: Cone Bars (Candy Canes)

    Traffic Cone Bar_Candy Cane.JPG
  • Are all vertical panels in good condition?

  • Are all warning lights in good condition?

  • Do all channelizing devices have appropriate battery mount?

  • Do all channelizing devices have appropriate appropriate ballasting?

  • Do all channelizing devices have adequate spacing?

  • Do all channelizing devices have adequate taper length?

  • MUTCD Reference Table

    Type of Taper & Length.JPG
  • Is the number of devices placed appropriately?

  • REFERENCE: MUTCD Minimum Devices on Taper

    Min. Devices on Taper.JPG

FLAGGING

  • Are all flaggers trained/certified?

  • Are flaggers alert and fit for duty?

  • Are flagger's cell phones put away and not in use during flagging operations?

  • Is there an escape route established for flaggers?

  • Are flaggers standing in pinch or crush points (Between traffic & other objects)

  • Are the flagger stations preceded by advance warning signs?

  • Are flaggers clearly visible to approaching traffic?

  • Are flaggers facing oncoming traffic at all times?

  • Are the flagger stations illuminated? (Night time)

  • Are flaggers using proper signaling devices? (Stop/Slow Paddles)

  • Are there portable radios issued and being used by flaggers to communicate?

  • Do flaggers have a way to communicate with the contractor on site?

  • Are flaggers wearing high visibility class 3 vests?

  • REFERENCE: Class 3 Vest (Sleeves with reflective)

    Class 3 Vest.JPG
  • Are flaggers wearing additional required PPE? (Hard Hat, Safety Glasses, Safety Toe Boots)

ROADSIDE SAFETY

  • Are all barriers in good condition?

  • Are all barrier delineation lights in good condition?

  • Are all barrier delineation reflectors in good condition?

  • Is there an adequate drop-off delineation?

  • Is there an adequate clear zone?

COMPLETION

  • Coaching Opportunities (Issues & areas for improvement)

  • Did you have a (Coaching) conversation with employees to resolve outstanding issues?

  • Were all issues resolved?

  • Overall assessment

  • Name and Signature of Supervisor or Safety Rep. Completing Audit

  • Name and Signature of Crew Leader

PHOTOS

  • Photo 1

  • Photo 2

  • Photo 3

  • Additional Photo

  • Additional Photo

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.