Information
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Site No.
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Site address
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Location
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Controller type
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Signal contractor
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Prepared by
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Conducted on
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Photo
Hardware
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Lanterns aimed
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Comment
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Removed old hardware
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Comment
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Traffic signs
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Comment
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Parking signs
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Comment
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Flashing amber
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Comment
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All displays working
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Comment
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Type of lanterns
- LED (240/42v)
- LED (240)
- Inc
- QH
- Inc/QH
- QH/LED
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Comment
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Flash test performed
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Comment
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Signed by VicRoads representative
Controller
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Operation
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Comment
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OP sheets
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Comment
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Fault card
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Comment
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Comms device
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Serial No.
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Locks
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Comment
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Stickers
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Comment
Detection
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Vehicle
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Comment
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Other detectors (specify)
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Comment
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Advance tram/tram/rail
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Comment
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Pedestrian push button
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Comment
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Pedestrian microwave
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Comment
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Railway link
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Comment
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Audio and type installed
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Comment
Other
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Safety camera
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Comment
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Linemarking, RPM, RRPM
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Comment
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Pavement reinstatement
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Comment
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Site clean and tidy
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Comment
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Civil works
- Pram crossings
- Asbestos pits
- Pits/pit lids
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Comment
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Trees trimmed
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Comment
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Public lighting
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Comment
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Pedestrian fences
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Comment
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Council attendance
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Comment
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Accidents
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Comment
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Metered power supply
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If yes, provide Meter Number or NMI
Power Consumption Readings
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Voltage
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Amps (min)
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Amps (max)
Parties
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Other comments
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Contractor
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VicRoads representative
