WORK ZONE TRAFFIC CONTROL INSPECTION FORM - Local

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ADVANCE WARNING SIGNS

NON-STANDARD SIGNS

• Appropriate Legend<br>

  Yes

  No

  N/A

• Color

  Yes

  No

  N/A

• Shape

  Yes

  No

  N/A

• Size

  Yes

  No

  N/A

SIGN QUANTITY:

• <br>Appropriate No. Of Signs<br><br>

  Yes

  No

  N/A

• Yes

• No

• <br>Missing Sign Series<br><br>

  Yes

  No

  N/A

• Yes

• No

• <br>Missing Specific Sign(s)<br><br>

  Yes

  No

  N/A

• Yes

• No

SIGN CONDITION

• Fair

• Poor

• Cleanliness<br><br>

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Legibility<br>

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Reflectivity

  Yes

  No

  N/A

• Good

Legends

• Fair

• Poor

• Appropriate Legends<br>

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Unneeded Signs Visible<br>

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Signs Post, No Work <br>

  Yes

  No

  N/A

• Good

SIGN PLACEMENT

• Height

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Visibility

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Spacing

  Yes

  No

  N/A

• Good

• Fair

• Poor

ARROW PANEL ( A,B,C,or D)

• Placement <br>

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Delineated / Shielded<br>

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Removed When Not In Use

  Yes

  No

  N/A

• Good

• Fair

• Poor

CHANNELIZING DEVICES

TYPE OF UPSTREAM TAPER (Circle One)

• Yes

  No

  N/A

• Merging

• Shifting

• Shoulder

• One-Lane, Two-Way

DOWNSTREAM TAPPER (Optional)

• Taper Length <br>Meters / Feet <br>

  Yes

  No

  N/A

• USED

  Yes

  No

  N/A

• No

• Yes

CHANNELIZING DEVICE CONDITION

DEVICE

• Barricades Type I, II, or III

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Drums

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Cones

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Tubular Markers

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Vertical Panels

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Warning Lights

  Yes

  No

  N/A

• Good

• Fair

• Poor

CHANNELIZING DEVICE CONDITION (Continued)

• Appropriate Ballasting

  Yes

  No

  N/A

• Yes

• No

• Appropriate Battery Mount

  Yes

  No

  N/A

• Yes

• No

• Adequate Spacing

  Yes

  No

  N/A

• Yes

• No

• Adequate Taper Length

  Yes

  No

  N/A

• Yes

• No

• Appropriate No. of Devices

  Yes

  No

  N/A

• Yes

• No

PAVEMENT MARKINGS

USE OF PAVEMENT MARKINGS

• Marking Used

  Yes

  No

  N/A

• Yes

• No

• Easily Understandable

  Yes

  No

  N/A

• Yes

• No

Condition

• Paint/Tape <br>

  Yes

  No

  N/A

• Good

• Obscured

• Faded

• Damaged/Dislodged

• Raised Markers

  Yes

  No

  N/A

• Good

• Obscured

• Faded

• Damaged/Dislodged

Flagging

Flagger Use

• Flagger(s) Used

  Yes

  No

  N/A

• Yes

• No

• No. of Flaggers <br>

  Yes

  No

  N/A

• Flagger Station Preceded By Advance Warning Signs

  Yes

  No

  N/A

• Yes

• No

• Flaggers Are Clearly Visible To Approaching Traffic

  Yes

  No

  N/A

• Yes

• No

• Approaching Traffic Has Sufficient Distance To Stop

  Yes

  No

  N/A

• Yes

• No

• Flagger Stations Illuminated (Night Time)

  Yes

  No

  N/A

• Yes

• No

• Signaling Device

  Yes

  No

  N/A

• Slow/Stop Paddles

• Flags

• <br>Communication Used Between Flaggers<br>

  Yes

  No

  N/A

• Visual Contact

• Two-Way Radio Contact

• Flagging Technique

  Yes

  No

  N/A

• Good

• Fair

• Poor

Flagger Attire

• High-Visibility Apparel

  Yes

  No

  N/A

• Yes

• No

• Hard Hats

  Yes

  No

  N/A

• Yes

• No

Roadside Safety

• <br>Type of Barrier<br>

  Yes

  No

  N/A

• Concrete

• Timber Curb

• Guide Rail

• Other

• Barrier Condition

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Flared End Treatment Needed

  Yes

  No

  N/A

• Yes

• No

• Impact Attenuator Needed

  Yes

  No

  N/A

• Yes

• No

BARRIER DELINEATION

• Lights

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Reflectors

  Yes

  No

  N/A

• Good

• Fair

• Poor

• Too Small

• Adequate Drop-Off Delineation

  Yes

  No

  N/A

• Yes

• No

• Adequate Clear Zone

  Yes

  No

  N/A

• Yes

• No

INTERNAL TRAFFIC CONTROL

• Yes

• No

• Communication Between Workers On Foot And Equipment Operators Has Been Established

  Yes

  No

  N/A

• Yes

• No

• <br>Communication Between Equipment Operators Has Been Established<br>

  Yes

  No

  N/A

• Yes

• No

• Contact Information For The General Contractor And Subcontractors Available

  Yes

  No

  N/A

• Yes

• No

• All Site Personnel Have Been Trained on The Specific Internal Traffic Control Plan (ITCP)

  Yes

  No

  N/A

• Yes

• No

• Worker and Visitor Parking Areas Have Been Designated

  Yes

  No

  N/A

• No

• Yes

• Independent Truck Drivers Have Been Oriented Prior to Entering The Work Space

  Yes

  No

  N/A

• Yes

• No

• Areas Around Specific Pieces of Equipment and Operations Have Been Delineated

  Yes

  No

  N/A

• Yes

• No

INTERNAL TRAFFIC CONTROL PLAN REQUIREMENTS

• Locations For Storing Materials And Servicing Equipment Have Been Designated

  Yes

  No

  N/A

• Yes

• No

• Internal Signs And Traffic Control Devices Have Been Posted/Erected

  Yes

  No

  N/A

• Yes

• No

• Adequate Lighting Has Been Provided For Night Operations

  Yes

  No

  N/A

• Yes

• No

• Speed Limit Within The Work Zone Has Been Posted

  Yes

  No

  N/A

• Yes

• No

• Channels Of Communication Regarding Changes To The ITCP Have Been Designated

  Yes

  No

  N/A

MISCELLANEOUS TRAFFIC CONTROL

CONDITION

• Unprotected Operations or Equipment In Roadway

  Yes

  No

  N/A

• Yes

• No

• Temporary Traffic Signal Operation/Installation Effective

  Yes

  No

  N/A

• Yes

• No

• Original Signs/Delineation In Good Condition

  Yes

  No

  N/A

• Yes

• No

• Posted Speed Limit

  Yes

  No

  N/A

• MPH

• Appropriate

• Too Fast

• Too Slow

• <br>Access Control<br>

  Yes

  No

  N/A

• Good

• Fair

• Poor

PEDESTRIAN SAFETY

• Adequate Travel Path<br>

  Yes

  No

  N/A

• Yes

• No

• Adequate Protection From Hazards

  Yes

  No

  N/A

• Yes

• No

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