Information

  • L2 Employee Responsible On Site

  • Audit Document Number

  • Invoice / Job Docket Number

  • Conducted on

  • Client / Site

  • Enter Client

  • Prepared By

  • Traffic Controller(s)

  • Location

Compulsory Requirements

  • Traffic Management Plan - Provided / Selected & Relevant

  • Approved Job Sheet - Times, Location & Company Details Correct

  • Council and/or police permits current and on site?

  • Safe Work Method Statement - Present & Relevant

Code of Practice & AS/NZS 1742.3 Requirements

  • Reduced Speed Relevant to Clearance

  • Permanent Speed Signs Covered Up

  • End Road Works / Return Speed in Place

  • Taper Set Adequately (line & length)

  • Lane Status Signs Set Correctly

  • Required Sign / Devices Available On Site

  • All Signage Spacing Approx / Correct

  • Signage Placed Allows Good Visibility

  • Arrow board in Use when Required

  • Speed Reduction Dual Signed

  • Dual Signed when Required

  • Speed Signs Set Closest to Road

  • Multi Frames Used Correctly (no gaps & correct heights)

  • Side Streets Signed

  • 2 Flags - 1st Sign & Speed Reduction

  • All Signs in Good Condition (class 1)

  • Cones & Bollards Correct Size

  • Stop / Slow Bat in Good Condition

Worksite

  • Bus Stops Accessible

  • Pedestrian Care Provided For (signed, no trip hazards)

Traffic Management

  • Sufficient T/C's Onsite

  • T/C's have L1 & L2 (where appropriate) Cards On Them

  • AS/NZS 4602 High Visibility Worn

Work Zone Seperation

  • Clearances from Works to Traffic Maintained

Other Road Users

  • Traffic Congestion Been Considered & Steps To Rectify

  • Other Road Users Been Considered & Provided For

  • Access to Side Roads & Properties Been Provided

Media

Signage

  • Approaching the worksite

  • Add media

  • On Side Road(s)

  • Add media

  • End Road Work

  • Add media

Worksite

  • Taper

  • Add media

  • Closure

  • Add media

  • Clearance from Works to Traffic

  • Add media

Pedestrian Management

  • Signage

  • Add media

  • Safety Measures

  • Add media

Other

  • If Applicable

  • Add media

M1 Checklist

Equipment Checklist

First Aid Kit

  • Present in Vehicle

  • Adequate Supply of First Aid Equipment

  • First Aid Sticker Present on Vehicle

Fire Extinguisher

  • Present in Vehicle

  • Pin is Inserted Correctly with Lock Tag Attached

  • Tag Stamp in In Date

Vehicle Folder

  • Present in Vehicle

  • Sufficient Supply of SWMS's

  • Sufficient Supply of Incident Reports

  • MUTCD Present

Vehicle Condition

  • Inside

  • Outside

  • Equipment / Storage

Aftercare Equipment

  • Is There any Equipment on Hire?

  • Ensure All Relevant Details Are Documented; including client, location & equipment

Traffic Controller Personal Equipment

  • All Items Must Be In Good Condition

  • TC Vest and Wet Weather Jacket In Good Condition

  • Altus Shirt Pressed and Tucked In

  • Altus Work Pants with Reflective Tape

  • Steel Capped, Above Ankle, Lace Up Boots

  • Hard Hat With Sun Rim

  • Is it on site?

  • UHF Radio

  • Is it on site?

  • ENERGEX Specific PPE

  • Night Wand

Summary

Employee Development

  • Development Required

  • Follow Up Required

Sign Off

  • Altus Supervisor

  • Altus Employee

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.