Title Page
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Prepared by
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Street name(s) and number (from/to)
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RCA permit reference
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Attended/Unattended
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Principal: Chorus - Visionstream
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Employer of site STMS
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Audit commences
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Rating: A = Acceptable NI = Needs Improvement D = Dangerous
SUMMARY OF STANDARDS
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STMS Name and Registration Number
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1. Responsible Party<br>STMS/TC at attended site?
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2. TMP
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On site?
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Appropriate to situation?
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3. High-visibility garments
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Worn by all?
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Done up?
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Condition acceptable?
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4. Signs
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All necessary signs present?
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Correct positions?
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Sand bagged for expected wind?
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Conflicting signs covered?
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Signs in good condition?
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If other - please note:
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Other?
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5. Delineation
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Protects working space/other features?
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Taper lengths compliant?
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Correct spacing of cones?
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Sufficient positive traffic control?
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If other - please note:
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Other?
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6. Pedestrian needs
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All necessary signs present?
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Footpath widths OK?
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Safe passage for pedestrians?
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Surface/ramps OK?
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If other - please note:
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Other:
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7. Cyclist needs
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Cycle widths OK?
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Safe passage for cyclists?
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Surfaces OK?
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If other - please note:
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Other:
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8. Traffic needs
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Lane widths OK?
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Speed limit appropriate?
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No significant delays?
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Surfaces OK?
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If other - please note:
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Other?
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9. Property access
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Property access OK?
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Number of Acceptable ratings:
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Number of Needs Improvement ratings:
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Number of Dangerous rating:
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Action agreed by STMS/TC
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Auditor
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Auditor signature
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STMS/TC signature
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Audit finished
