Title Page
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Conducted on
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Document No. 000004
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Location
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Prepared By
- M. Abel
- M. Murray
- S. Gray
- T. Wylie
- M. Geldhill
- D. Sullivan
- D. Moors
- C. Coppleman
- A. Lee
- D. Lockley
- K. Miles
- M. Fisher
- W. Kyle
- C . Papadopulos
- S. Walker
- T. Fraser
- P. Pickering
- J. Laredo
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Road configuration
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Site details
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Customer
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On-site contact
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Phone
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Signature
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Order number
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Site Address
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Traffic controller name
- M. Abel
- M. Murray
- S. Gray
- T. Wylie
- M. Geldhill
- D. Sullivan
- D. Moors
- C. Coppleman
- A. Lee
- D. Lockley
- K. Miles
- M. Fisher
- W. Kyle
- C . Papadopulos
- S. Walker
- T. Fraser
- P. Pickering
- J. Laredo
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On-site start time
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On-site finish time
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TMP generic or site specific
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TMP no
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Time signs placed
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Time signs removed
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Time signs reviewed
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Road permit required
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Estimated traffic volume
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Have changes been made to TMP
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Reason for changes
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Type of road
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Start date
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End date
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Weather
- Fine
- Rain
- Overcast
- Windy
- Fog
- Snow/ice
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Road characteristics
- Straight
- Curve
- Intersection
- Roundabout
- Hill
- Winding
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Visibility
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No of lanes
- 1
- 2
- 3
- 4
- 5
- 6
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Road surface
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Traffic control
- Stop/slow
- Lane closure
- Lateral shift
- Detour
- Road closure
- Roundabout
- Speed reduction
- Pedestrian control
- Arrow board
- Intersection
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Setup checklist for traffic controller
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Signage erected as per TMP
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After care signage left on site
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Docket number
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Deviation from TMP required (if YES write in hazards & authorisation)
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List alterations
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Conflicting signage covered/removed
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Signs securely mounted & visible to traffic
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Have sand bags been placed
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Stop/slow bat to be used to control traffic
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Escape route planned for each traffic controller
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Distance of 30m maintained from worksite
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List any additional hazards & control measures
