Traffic management report - local copy

• Document No.

• Job Title

• Client

  Select Sealing NZ Broadspectrum Veolia Northpower A1 Directional Drilling other Downer CWNOC Higgins EWNOC Downer

  • Sealing NZ
  • Broadspectrum
  • Veolia
  • Northpower
  • A1 Directional Drilling
  • other
  • Downer CWNOC
  • Higgins EWNOC
  • Downer

• Enter Client Name Here

• Location of Job
  Address

Job details

• TMP Number:

• Type of Closure:

  Select Mobile Semi Static Shoulder Closed Contra-flow Lane Closure Road Closure Event MTC ( stop / go ) lane width reduction

  • Mobile
  • Semi Static
  • Shoulder Closed
  • Contra-flow
  • Lane Closure
  • Road Closure
  • Event
  • MTC ( stop / go )
  • lane width reduction

• Shift Time

  Day

  Night

• TSL Already Installed?

  Yes

  No

  N/A

• TSL Installed:

  Date

• TSL Removed:

  Date

• Location of TSL installed

• Weather Conditions:

  Select Fine Sun Strike Overcast Dizzly Rain Heavy Rain Wind Heavy Wind Snow Cold Hot

  • Fine
  • Sun Strike
  • Overcast
  • Dizzly
  • Rain
  • Heavy Rain
  • Wind
  • Heavy Wind
  • Snow
  • Cold
  • Hot

• Work Operations:

• STMS for site

• TC Delegation

• TC delegation - sign to confirm receipt of site and briefing conducted

  Sign

Closure Equipment Checks (Check PPE, Safety Jackets, Cones, Signs...)

Check Number

• Comments/Conditions: (Note any missing signs, signs or cones down, etc...)

• Select date

  Date

• Signed:

  Sign

Accidents/Incidents:

• Accidents/Incidents:

Accident/Incident

• Accident/Incident Description:

• Event Report Filed Out?

  Yes

  No

• Signed

  Sign

• Date/Time of Incident

  Date

Hazard identification

• Hazard Identification

  Select Traffic - TTM in place, safety zones, PPE, TMP, STMS, be aware Visibility - Additional signage, Beacons, Work Lights, Flags / Wands, additional delineation Speed - TSL, Side friction cones, narrow lane widths Night Works - wands, beacons, work lights, spotters, be aware, PPE Emergency Services (fire, ambulance, police) - keep clear, give full priority , stms to assist if required Hot Products - PPE, keep clear, burns cards Plant / Equipment - Trained / Qualified / Competent operations only, Correct PPE Pedestrians - 1.2m lanes maintained, spotters, walkways keep clear, be aware Noise - PPE, keep clear, be mindful Contractor movements - TTM, spotters, safety zones, beacons, stms Weather - PPE, be mindful, STMS to monitor visibility and safety aspect Slips, Trips, Falls - Boots laced up, Watch footing, House keeping, be aware Dust - PPE, Be mindful, Keep clear Open Manholes - Always manned, Barrier off, Close lid when not attended

  • Traffic - TTM in place, safety zones, PPE, TMP, STMS, be aware
  • Visibility - Additional signage, Beacons, Work Lights, Flags / Wands, additional delineation
  • Speed - TSL, Side friction cones, narrow lane widths
  • Night Works - wands, beacons, work lights, spotters, be aware, PPE
  • Emergency Services (fire, ambulance, police) - keep clear, give full priority , stms to assist if required
  • Hot Products - PPE, keep clear, burns cards
  • Plant / Equipment - Trained / Qualified / Competent operations only, Correct PPE
  • Pedestrians - 1.2m lanes maintained, spotters, walkways keep clear, be aware
  • Noise - PPE, keep clear, be mindful
  • Contractor movements - TTM, spotters, safety zones, beacons, stms
  • Weather - PPE, be mindful, STMS to monitor visibility and safety aspect
  • Slips, Trips, Falls - Boots laced up, Watch footing, House keeping, be aware
  • Dust - PPE, Be mindful, Keep clear
  • Open Manholes - Always manned, Barrier off, Close lid when not attended

• Other site specific hazzards

  Yes

  No

• PPE required

  Select hard hats long sleeve shirts and pants safety glasses steel capped safety boots fire retardant overalls gloves hearing protection hi visibility transit compliant safety vest

  • hard hats
  • long sleeve shirts and pants
  • safety glasses
  • steel capped safety boots
  • fire retardant overalls
  • gloves
  • hearing protection
  • hi visibility transit compliant safety vest

• Sign

  Sign

• Sign

  Sign

• Sign

  Sign

• Sign

  Sign

• Sign

  Sign

• Sign

  Sign

• Sign

  Sign

• Sign

  Sign

• Sign

  Sign

• Sign

  Sign

Client sign off

• Road level

  Select level 1 level 2 level 3

  • level 1
  • level 2
  • level 3

• Closure type

  Select Mobile Semi Static Shoulder Closed Contra-flow Lane Closure Road Closure Event MTC ( stop / go ) lane width reduction

  • Mobile
  • Semi Static
  • Shoulder Closed
  • Contra-flow
  • Lane Closure
  • Road Closure
  • Event
  • MTC ( stop / go )
  • lane width reduction

• Yard start

  Date

• Onsite time

  Date

• Offsite time

  Date

• Yard finish

  Date

• Services supplied

  Select Stms only stms and vehicle stms, tc and vehicle stms, 2 X tc and vehicle stms, 3 X tc and vehicle stms, 4 X tc and vehicle

  • Stms only
  • stms and vehicle
  • stms, tc and vehicle
  • stms, 2 X tc and vehicle
  • stms, 3 X tc and vehicle
  • stms, 4 X tc and vehicle

• Staff onsite