Title Page

  • Site Name

  • Date and Time of Inspection

  • Project Number

  • Competent Person

  • Inspected by

  • Location

Checklist

GENERAL INFORMATION

  • Project description

  • Take a photo of the project

  • List down the name of employees

  • List down the vehicles on scene

  • Type of Roadway

  • Posted Speed Limit

  • Weather/Light Conditions

  • Traffic Conditions

TEMPORARY TRAFFIC CONTROL

ADVANCE WARNING SIGNS

  • Is there an appropriate number of signs placed?

  • Are all signs in good condition (clean, legible, and reflective)?

  • Do all sign placements (height, visibility, and spacing) conform to standard regulation?

CHANNELIZING DEVICES

  • Are all barricades in good condition?

  • Are all drums in good condition?

  • Are all safety cones in good condition?

  • REFERENCE: Safety cones in good condition
    [This is an example of how you can use iAuditor to include best practice reference images in your templates to assist with inspections]

    safety cones ref.jpg
  • Are all tabular markers in good condition?

  • Are all vertical panels in good condition?

  • Are all warning lights in good condition?

  • Do all channelizing devices have appropriate battery mount?

  • Do all channelizing devices have appropriate appropriate ballasting?

  • Do all channelizing devices have adequate spacing?

  • Do all channelizing devices have adequate taper length?

  • Is the number of devices placed appropriately?

PAVEMENT MARKINGS

  • Are there any pavement markings used?

  • Are all pavement markings easy to understand?

  • Are all pavement markings in good condition? (paint/tape and raised markers)

FLAGGING

  • Are all flaggers trained/certified?

  • Is there an escape route established for flaggers?

  • Are the flagger stations preceded by advance warning signs?

  • Are flaggers clearly visible to approaching traffic?

  • Are the flagger stations illuminated? (Night time)

  • Are there signaling devices provided for flaggers?

  • Are there portable radios issued for flaggers?

  • Do all flaggers wear high visibility vests?

  • Do all flaggers wear appropriate PPE?

ROADSIDE SAFETY

  • Are all barriers in good condition?

  • Are all barrier delineation lights in good condition?

  • Are all barrier delineation reflectors in good condition?

  • Is there an adequate drop-off delineation?

  • Is there an adequate clear zone?

INTERNAL TRAFFIC CONTROL

  • Are all site personnel trained on the specific Internal Traffic Control Plan (ITCP)?

  • Are there parking areas designated for workers and visitors?

  • Is orientation conducted for independent truck drivers prior to entering the workspace?

  • Are the areas around specific pieces of equipment and operations delineated?

  • Are there designated locations for storing materials and servicing equipment?

  • Are there internal signs and traffic control devices posted/erected?

  • Is there a posted speed limit within the work zone?

  • Is there an adequate lighting provided for night operations?

  • Are brightly colored vests with retroreflectivity utilized to allow workers to be visible 1,000 feet in all directions

  • Is there a designated channel of communication regarding changes to the ITCP?

  • Is there an established communication between workers on foot and equipment operators?

  • Is there an established communication between equipment operators?

COMPLETION

  • Overall recommendations

  • Overall assessment

  • Name and Signature of Inspector

  • Name and Signature of Competent Person

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.