Title Page

  • Conducted on

  • Prepared by

  • InfraSource Foreman

  • Southpointe Personnel

  • Location

General Procedure

  • Is the Southpointe Daily JHA complete?

  • Has the Southpointe JHA been signed/reviewed by all Southpointe personnel?

  • Has the Southpointe JHA been signed/reviewed by all InfraSource personnel?

  • Is the NiSource Work Zone Planning Form accurately completed?

  • Is the NiSource Work Zone Inspection Form accurately completed up to the point of audit?

  • Do all Southpointe personnel have a valid flagger certification?

  • Is the flagger certification visible on all Southpointe personnel?

  • Do all Southpointe personnel have on a hardhat?

  • Do all Southpointe personnel have on safety glasses?

  • Do all Southpointe personnel have on a safety whistle?

  • Do all Southpointe personnel have on a Class III Vest?

  • Do all Southpointe personnel have on Class E pants?

  • Do all Southpointe personnel have on Steel Toed Boots?

  • Do all Southpointe personnel have functioning 2-Way Radios?

  • Is the Southpointe work vehicle parked in a safe position?

  • Does the Southpointe work vehicle have cones at the front and rear bumpers?

Work Zone

  • What type of work zone is present during audit?

  • Is the audit taking place during site setup?

  • Did one of the flaggers act as a spotter while setting signs?

  • Did the flaggers unload equipment from the side of the vehicle?

  • Were the strobe lights utilized on the traffic control vehicle?

  • Does this setup consider both worker safety and best possible flow of traffic?

  • Are the appropriate mainline lead-in signs present?

  • Are the signs placed in the shoulder of the roadway?

  • Is the speed limit greater than 35 mph?

  • Are the mainline lead-in signs spaced at a 350' minimum?

  • Are the mainline lead-in signs spaced at 100' minimum?

  • How many side road approaches require signage?

  • Was this road signed?

  • How many roads were signed?

  • How many roads were signed?

  • How many roads were signed?

  • How many roads were signed?

  • How many roads were signed?

  • How many roads were signed?

  • How many roads were signed?

  • Are all signs clearly visible without any obstructions?

  • Is signage condition acceptable?

  • Is there adequate site distance the flagger stations?

  • Is an upstream taper present?

  • Does the upstream taper have a minimum of 6 cones?

  • Is the upstream taper a minimum of 50' long?

  • Is a downstream taper present?

  • Does the downstream taper have a minimum of 6 cones?

  • Is the downstream taper a minimum of 50' long?

  • Does the zone have an adequate buffer space?

  • Are the tangent cones present?

  • Are the tangent cones spaced correctly?

  • Are the sidewalks closed where work or equipment is present?

  • Are there "Sidewalk Closed" signs at the area of work?

  • Are there cone bars at the sidewalk closure preventing pedestrian access?

  • Are there "Sidewalk Closed Ahead, Cross Here" signs at each end of the sidewalk?

  • Are there cones around all InfraSource equipment that is present?

  • Are all open trenches/holes coned off?

  • Are there cone bars at all open trenches/holes?

  • Are steel plates readily available to allow access for emergency vehicles/school buses?

  • Are there enough flaggers present?

  • Are flaggers properly positioned?

  • Do flaggers have a means of escape?

  • Are flaggers utilizing a "Stop-Slow Paddle?"

  • Are flaggers using proper hand gestures for a "Stop-Slow Paddle?"

  • Are there any flaggers stationed in an intersection?

  • Are the flaggers in intersections using red flags?

  • Are flaggers using proper hand gestures to direct traffic?

  • Are flaggers communicating clearly with one another?

  • Are flaggers attentive and aware of their surroundings?

  • Is the audit taking place during site tear down?

  • Was all equipment loaded from the side of the vehicle?

  • Did one of the flaggers act as a spotter while taking signs down?

  • Did the the traffic control vehicle use its strobe lights during tear down?

  • Are there any steel plates present in the roadway?

  • Are there "Steel Plate Ahead" signs present?

  • Did the InfraSource foreman and flaggers have a post job briefing?

  • Did the flaggers ask for information about the work being performed the following day?

  • Is the audit taking place during site setup?

  • Did one of the flaggers act as a spotter while setting signs?

  • Did the flaggers unload equipment from the side of the traffic control vehicle?

  • Were the strobe lights being utilized on the traffic control vehicle?

  • Does this setup consider both worker safety and best possible flow of traffic?

  • Are the appropriate mainline lead-in signs present?

  • Are the mainline lead-in signs placed on the shoulder of the road?

  • Is the speed limit greater than 35 mph?

  • Are the mainline lead-in signs spaced at a 100' minimum?

  • Are the mainline lead-in signs spaced at a 350' minimum?

  • How many side road approaches require signage?

  • How many roads were signed?

  • How many roads were signed?

  • How many roads were signed?

  • How many roads were signed?

  • How many roads were signed?

  • How many roads were signed?

  • How many roads were signed?

  • How many roads are signed?

  • Are all signs clearly visible without any obstructions?

  • Is signage condition acceptable?

  • Is there adequate sight distance to the closure?

  • Are there cones present on each side of the "Road Closed" sign?

  • Are there cone bars present at the point of closure to help prevent access?

  • Are the sidewalks closed where work or equipment is present?

  • Are there "Sidewalk Closed" signs at the point of closure?

  • Are there cone bars at the sidewalk closure preventing access?

  • Are there "Sidewalk Closed Ahead, Cross Here" signs at each end of the sidewalk?

  • Are there cones around all InfraSource Equipment that is present?

  • Are all open trenches/holes coned off?

  • Are there cone bars present around all open trenches/holes?

  • Are steel plates readily available to allow access for emergency vehicles/school buses?

  • Are flaggers properly positioned at the closure?

  • Do flaggers have a means of escape?

  • Are all flaggers using their red flag?

  • Are flaggers communicating clearly with one another?

  • Are flaggers attentive and aware of their surroundings?

  • Is the audit taking place during site tear down?

  • Was all equipment loaded from the side of the vehicle?

  • Did one of the flaggers act as a spotter while taking down signs?

  • Were the strobes being utilized on the traffic control vehicle?

  • Are there any steel plates on the roadway?

  • Are there "Steel Plate Ahead" signs present?

  • Did the InfraSource foreman and flaggers have a post job briefing?

  • Did the flaggers ask for information about the next day's traffic setup?

  • Is the audit taking place during site setup?

  • Did one of the flaggers act as a spotter while setting signs?

  • Did the flaggers unload equipment from the side of the vehicle?

  • Was the Arrow Board secure during transit?

  • Were the safety chains crossed under hitch and secure?

  • Were the strobe lights utilized on the traffic control vehicle?

  • Does this setup consider both worker safety and best possible flow of traffic?

  • Are the appropriate mainline lead-in signs present?

  • Are the mainline lead-in signs placed in the shoulder of the road?

  • Is the speed limit greater than 35 mph?

  • Are the mainline lead-in signs spaced at a 100' minimum?

  • Are the mainline lead-in signs spaced at a 350' minimum?

  • How many side road approaches require signage?

  • How many roads were signed?

  • How many roads were signed?

  • How many roads were signed?

  • How many roads are signed?

  • How many roads are signed?

  • How many roads are signed?

  • How many roads are signed?

  • How many roads are signed?

  • Are all signs clearly visible and free from any obstructions?

  • Is signage condition acceptable?

  • Is the Arrow Board placed in the correct position according to PUB 213/MUTCD standards?

  • Are all support legs on the Arrow Board secure and making contact with the roadway?

  • Is the Arrow Board flashing in the correct direction?

  • Is a Merging Taper present?

  • Does the Merging Taper have the correct number of devices for this specific roadway?

  • Is the Merging Taper the correct length per PUB 213/MUTCD standards?

  • Is a termination taper present?

  • Does the termination taper have the correct number of devices per PUB 213/MUTCD standards?

  • Does the work zone have an adequate buffer space?

  • Are the tangent cones present?

  • Are the tangent cones spaced correctly?

  • Are the sidewalks closed where work or equipment is present?

  • Are there "Sidewalk Closed" signs where the sidewalk is closed?

  • Are there cone bars at the sidewalk closure to prevent access?

  • Are there "Sidewalk Closed Ahead, Cross Here" signs at each end of the sidewalk?

  • Are there cones around all InfraSource equipment that is present?

  • Are all open trenches/holes coned off?

  • Are there cone bars present at all open trenches/ditches?

  • Are steel plates readily available to allow access to emergency vehicles/school buses?

  • Are flaggers properly positioned?

  • Do flaggers have a means of escape?

  • Are all flaggers using a red flag?

  • Are flaggers communicating clearly with one another?

  • Are flaggers attentive and aware of their surroundings?

  • Is the audit taking place during site tear down?

  • Did the flaggers demobilize the zone working from downstream to upstream?

  • Was all equipment loaded from the side of the vehicle?

  • Did one of the flaggers act as a spotter while taking signs down?

  • Were the strobe lights utilized on the traffic control vehicle?

  • Was the Arrow Board secure during transit?

  • Were the safety chains crossed under hitch and secure?

  • Are there any steel plates present in the roadway?

  • Are there "Steel Plate Ahead" signs present?

  • Did the InfraSource foreman and flaggers have a post job briefing?

  • Did the flaggers ask for information about the work being performed the following day?

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