WORK ZONE TRAFFIC CONTROL INSPECTION FORM

Contract No. Project No.

Date / Time / / : a.m. □ p.m. □

Location Caza

No. of Lanes Posted Speed Limit km/h

Weather / Lighting Conditions Work Type

ADVANCE WARNING SIGNS

SIGN QUANTITY SIGN CONDITION Good Poor

Appropriate No. of Signs No Cleanliness  

Yes

Yes No  Legibility  
Missing Sign(s)
Reflectivity  

LEGENDS Yes No SIGN PLACEMENT Good Poor

Appropriate Legends   Height  

(Explain)

Unneeded Signs Visible   Visibility  

(Explain)

Signs Posted, No Work   Spacing  

(Explain)

ARROW PANEL Good Poor

Placement  

Delineated / Shielded

Removed When Not In Use

CHANNELIZING DEVICES

TYPE OF UPSTREAM TAPER (Check One) DOWNSTREAM TAPER (Optional)

Merging  Shifting  Used Yes  No 

Shoulder  One-Lane, Two-Way  Taper Length (m)

 CHANNELIZING DEVICE CONDITION
DEVICE Good Poor DEVICE Yes No
Barriers  
(Explain) Adequate Spacing
Drums  
(Explain) Adequate Taper Length
Cones  
(Explain) Appropriate No. of Devices
Tubular Markers   
(Explain) Non-Standard Device
Vertical Panels  
(Explain)

Warning Lights  
(Explain)

PAVEMENT MARKINGS
Damaged /
USE OF PAVEMENT MARKINGS CONDITION Good Faded
Dislodged
Markings Used Yes No Paint / Tape


Understandable Yes No 
Raised Markers
Conflicting marking Removed Yes No

FLAGGING
FLAGGER USE FLAGGER ATTIRE
Flagger(s) Used Yes  No  No. of Flaggers High-Visibility Apparel

Flagger Station Preceded By Advance Warning Signs Yes  No  Yes  No 

(Explain) (Explain)

Flaggers Are Clearly Visible To Approaching Traffic Yes  No 

(Explain)
Communication Used
Approaching Traffic Has Sufficient Distance To Stop Yes  No  Between Flaggers
(Explain)

Flagger Stations Illuminated (Night Time) Yes  No  N/A  Visual Contact 

Signaling Device Slow / Stop Paddles  Flags  Two-Way Radio Contact 

Flagging Technique
Good  Poor 
(Explain)

ROADSIDE SAFETY
Portable Barrier Used Yes  No  BARRIER DELINEATION
Barrier Condition Good  Poor  Lights Good  Not Working (Explain)
(Explain)

Barriers Properly Connected Yes  No 

(Explain) Reflectors Good  Poor (Explain)

Impact Attenuator Used Yes  No  Vertical Panels Good  Poor  (Explain)

Impact Attenuator Condition Good  Poor 
(Explain)
 MISCELLANEOUS TRAFFIC CONTROL
CONDITION YES NO
Was temporary traffic control installed in a safe manner

Unprotected Operations Or Equipment In Roadway  

(If Yes, Explain)


Temporary Traffic Signal Operation / Installation Effective  (If No, Explain)


Original Signs / Delineation In Good Condition  (If No, Explain)

Access Control Good  Poor  (Explain)

PEDESTRIAN SAFETY
Are sidewalks / walking No  No 
Yes  Is an alternate ADA route provided Yes 
paths affected (Explain) (Explain)

No  Are equipment, materials, or other No 

Are signs clean and legible Yes  Yes 
(Explain) items blocking sidewalk (Explain)

Is the path free of debris No  Does the pedestrian route maintain No 

Yes  Yes 
and tripping hazards (Explain) ADA minimum 36” width (Explain)

Deficiencies Found (Include location):

Deficiencies Found (continued)

OVERALL RATING: Excellent_________ Adequate_________ Inadequate___________