VicRoads Roads in Poor Condition Report

• Conducted on

  Date

• Prepared by

• Position Title

• Location
  Address

• Site Inspection Report No:

• Roads in Poor Condition Register Reference No:

• Skid Resistance Inspection Reference No:

1.1 Location

• Road Name:

• Road No.

• Map Ref:

• LGA:

• Direction:

  Forward

  Reverse

• Kilometre Post / SRRS Start:

• Kilometre Post / SRRS End:

• Site Length (m):

• Site Width (m):

• Total Area (m2):

• Local Description:

• Road Maintenance Category:

  1

  2

  3

  4

  5

• Current Hazard Inspection Regime:

  Daily

  Twice Weekly

  Weekly

  Every 2nd Week

  Monthly

• Is this response from an ETS?

  Yes

  No

• ETS Reference No/s (If Yes above):

• Description of Defect / Condition:

• Suggested Treatment Category

  Rehabilitation

  Periodic

  Skid Resistance

• Photos Taken:

  Yes

• Photo References:

1.2 Signage

1.2.1 Signage - Existing Signage on site

• Posted Speed Limit:

  Select 40 kph 50 kph 60 kph 70 kph 80 kph 90 kph 100 kph 110 kph

  • 40 kph
  • 50 kph
  • 60 kph
  • 70 kph
  • 80 kph
  • 90 kph
  • 100 kph
  • 110 kph

• Existing Warning Signs:

  Select Curves / Alignment Intersections Advanced Warning of Traffic Control Devices Road width Low Clearance Narrow Clearance Road Obstacles Pedestrian Bicycle School

  • Curves / Alignment
  • Intersections
  • Advanced Warning of Traffic Control Devices
  • Road width
  • Low Clearance
  • Narrow Clearance
  • Road Obstacles
  • Pedestrian
  • Bicycle
  • School

• Other Comments:

1.2.2 Signage - Temporary Signs Installed

• Are Temporary Warning Signs Installed:

  Yes

• If Yes, are the Temporary Warning Signs:

  Portable

  Fixed

• Type of Temporary Signs Installed:

  Rough Surface

  Uneven Surface

  Slippery When Wet

• Other Temporary Warning Signs Installed:

• Are Temporary Speed Limit Signs Installed:

  Yes

• If Yes, are the Temporary Speed Limit Signs:

  Portable

  Fixed

• If Yes, are the Temporary Speed Limit Signs:

  Regulatory

  Advisory

• Temporary Speed Limit Installed:

  Select 40 kph 50 kph 60 kph 70 kph 80 kph 90 kph 100 kph 110 kph

  • 40 kph
  • 50 kph
  • 60 kph
  • 70 kph
  • 80 kph
  • 90 kph
  • 100 kph
  • 110 kph

• Date Signs Installed:

  Date

• MoA Reference No (If applicable):

• MoA Expiry Date (If applicable):

  Date

• Asset Vision No with photos of signs installed:

• Advise Victoria Police on speed changes:

  Date

• Other Comments:

• Has the VicRoads Guideline for Signing Roads in Poor Condition been used for signing the site?

• Site Sketch Plan attached (Appendix 1)

• Number of times the Contractor has repaired the site

• How frequently the site requires maintenance treatments to repair defects (Common defect types and treatment applied and frequency)

• Any other comments

• Is it required to install Fixed Speed Reduction/Advisory Speed signs?

  Yes

• If yes, forward to Movement and Safety to complete Section 2 (Date forwarded)

  Date

• If No, forward to Roads Development team to complete Section 3

  Date