Title Page

  • Document No.

  • Road name

  • Location
  • Department

  • Conducted on

  • Department

  • Supervisor name?

  • traffic controller team leader name

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  • Traffic management company

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  • TGS Prepared by

  • TCC department

  • Nature of work

  • Road configuration


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  • Are traffic controller licenses current

  • Are traffic controller licenses on the person

  • Has the daily risk assessment been completed

  • Is a copy of the MUTCD held on site

  • Is the MUTCD the current edition

  • Has daily risk assessment been completed?

Pre start

  • Is there a council order for these works

  • Is there a TMR permit for these works

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  • Is there a Queensland Police Permit on site for these works

  • Is there a site appropriate TGS on site for these works

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  • Has site / toolbox meeting been completed

  • Has an outline of,intended works been completed

  • Was the outline communicated to all staff

  • Has a site risk assessment been completed for these works

  • Do traffic controllers have sufficient access to amenities


  • Is the TRAFFIC GUIDANCE SCHEME relevant for the intended works

  • Has the pre-approved TRAFFIC GUIDANCE SCHEME been amended in any way

  • Is the TRAFFIC GUIDANCE SCHEME compliant

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  • Are the signs placed correctly (eg set out distances allowing for terrain and any obstructions)

  • Are the signs visible

  • Are the speed reductions in the correct steps

  • Are all approaches considered and signed appropriately

  • Are they mounted at the correct height

  • Are the signs in serviceable condition

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  • Are there any contradictory, distracting or superfluous signs or markings

  • Are END ROADWORKS signs installed where requierd

  • Are the speed restoration installed where required with the correct speed

  • Are the signs checked periodically


  • Is the taper clear and understandable to approaching traffic

  • Is the taper length sufficient as per the MUTCD

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  • Is the delineation suitable and leaves no doubt which part of the road way is available for traffic

  • If traffic cones/bollards are used are they the correct size and placed at 5-25 meter spacing

  • Is the colour of the delineation acceptable and are the cones in good condition

  • If cones/bollards are used at night are they fitted with white retro-reflective bands

Traffic control

  • Has public transport been considered

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  • Are communications adequate between traffic controllers

  • Are traffic controllers receiving regular breaks as per M.U.T.C.D

  • Are STOP/SLOW bats of the correct type and in good condition and at the correct height

  • Are the traffic controllers located in the best position and have a suitable escape path

  • Have side roads and access points been adequately catered for

  • Are traffic controllers operating in a 60 kp/h or less speed zone

  • Are TRAFFIC CONTROLLER AHEAD/PREPARE TO STOP signs located the required distance in advance of traffic controllers

  • Are TRAFFIC CONTROLLER / PREPARE TO STOP signs being removed when traffic controllers are not in attendance

  • Are WORKMEN SYMBOLIC signs in place as per the M.U.T.C.D

  • Are WORKMAN SYMBOLIC signs removed when not required (eg when no workers are present or visible )

  • Are portable traffic lights, VMS and arrow boards used correctly

Health and safety

  • Are satisfactory risk controls in place when workers are working close to moving and/or reversing plant. (Eg communications systems, spotters, eye contact etc)

  • Are pedestrians and plant effectively segregated or catered for

Pedestrian and cycle movement

  • Are suitable protected crossing points

  • Are appropriate signs and barricades provided and leave no doubt for pedestrians and cyclists

  • Has a safe and delineated passage been provided for pedestrians and cyclists around work zone

  • Have wheel chairs been clattered for ( eg temporary ramps and navigable paths)

  • Have cyclists, strollers and prams been catered for

  • Are minimum widths of temporary facilities appropriate

Traffic controller and appropriate PPE

  • Correct traffic control attire being used and in good condition

  • Approved hard hat with shade brim or approved wide brim hat worn

  • Safety footwear worn. Class 1 steel capped boots

  • Two way radios in working order

  • Safety sunglasses worn

  • Night wands used correctly and in working order -night work only

  • Bowyangs or similar lower body retro-reflective garments worn -night work only

  • Clear safety glasses worn - night work only

  • Are traffic controllers safely lit and clearly visible- night work only

General comments or opportunities for improvement

  • Photos / comments

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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.