Traffic Management JSEA

• Date

  Date

• Name

• By signing this, you confirm all hazards have been identified and controls are in place and the persons listed on this document have been informed of these hazards and controls.

  Sign
• Location
  Address

• Case number

• Estimated vehicles per day

• Permanent Traffic Speed (Kph)

• Worksite Traffic Speed (Kph)

• Risk Rating

  Low

  High

• Clearance between workers & traffic (metres)

• Which Temporary Guidance Scheme (TGS) is being used?

• Please upload photo of TGS being used

  Media

• Please upload photo of Mud Map

  Media

Planning

• Has a traffic management plan been selected or provided?

  Yes

  No

• Is plan available for inspection?

  Yes

  No

• Is plan relevant for the work?

  Yes

  No

• Are written authorisations for temporary roadwork speed limits required/in order?

  Yes

  No

• Are documented changes to traffic management plans available for inspection?

  Yes

  No

• Have temporary roadwork speed limits been determined correctly?

  Yes

  No

  N/A

Advance Warning / SIgnage

• Are all roadwork signs and devices installed according to the Traffic management plan?

  Yes

  No

• Have any contradictory, distracting or superfluous signs or markings been covered up or removed?

  Yes

  No

  N/A

• Are signs appropriate for current conditions? i.e. symbolic worker visible?

  Yes

  No

• Is signage suitably placed, especially for vehicles approaching at high speed?

  Yes

  No

• Are multi message signs being used correctly?

  Yes

  No

  N/A

• Are signs free from damage and defect?

  Yes

  No

• Are sign mountings secure, stable and not a hazard to road users if struck?

  Yes

  No

• Are signs in pairs (gated) where needed?

  Yes

  No

  N/A

• Are flashing arrow signs available and in use where required?

  Yes

  No

  N/A

• Are sign sizes correct?

  Yes

  No

  N/A

Worksite

• Are all Traffic Control personnel wearing safety helmets, safety eyewear and other required PPE?

  Yes

  No

• Are all Traffic Control personnel wearing high visibility clothing appropriate to conditions and worn correctly?

  Yes

  No

• Are clearances between workers and adjacent traffic maintained?

  Yes

  No

Other Road Users

• Has possible traffic congestion been considered and steps taken to avoid it?

  Yes

  No

  N/A

• Have the effects of the works on public transport been considered?

  Yes

  No

  N/A

• Have the needs of other road users been provided for?

  Yes

  No

• Has proper access to side roads and properties been provided?

  Yes

  No

  N/A

Traffic personnel (In addition to person completing JSEA)

• By signing this, you acknowledge you have read, understand and will comply with this document.

  Sign
Additional site personnel

• By signing this, you acknowledge you have read, understand and will comply with this document.

  Sign

Site Photos (Optional)

• Site photo

  Media