## WORK ZONE TRAFFIC CONTROL INSPECTION FORM

> Project No. D \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ PIN
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Region \_\_\_\_\_\_\_\_ Date
> \_\_\_\_\_\_\_\_\_ Fed Aid? \_\_\_\_\_\_\_\_\_
>
> Location
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Weather/Lighting Conditions
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Project
> Type:
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> **CONSTRUCTION SIGNING/ADVANCE WARNING**

  ------------------- ------------ ------------------- ------------ ------------ ------------
  **Quantity of                                        **Good**     **Fair**     **Poor**
  Signs:**                                                                       

       Good                        **Sign Condition:**                             
                      \_\_\_\_\_                       \_\_\_\_\_   \_\_\_\_\_   \_\_\_\_\_
                                                                                   

       Too many                         Rigid sign                                 
                      \_\_\_\_\_                       \_\_\_\_\_   \_\_\_\_\_   \_\_\_\_\_
                                                                                   

       Missing sign                     Flexible sign                              
  series              \_\_\_\_\_                       \_\_\_\_\_   \_\_\_\_\_   \_\_\_\_\_
                                                                                   

       Missing                          Reflectivity                               
  specific sign       \_\_\_\_\_                       \_\_\_\_\_   \_\_\_\_\_   \_\_\_\_\_
                                                                                   

  **Credibility of                                                                
  Text:**                                                                        

       Good                        **Arrowboard Use:**                             
                      \_\_\_\_\_                       \_\_\_\_\_   \_\_\_\_\_   \_\_\_\_\_
                                                                                   

       Misleading                       Placement                                  
  sign text           \_\_\_\_\_                       \_\_\_\_\_   \_\_\_\_\_   \_\_\_\_\_
                                                                                   

       Unneeded signs                   Performance                                
  visible             \_\_\_\_\_                       \_\_\_\_\_   \_\_\_\_\_   \_\_\_\_\_
                                                                                   

       Countdown but                                                              
  no work             \_\_\_\_\_                                                 
                                                                                 

  **Sign Placement:**              **Non-standard                                 
                                   signs:**                                      

       Good                             Text                                      
                      \_\_\_\_\_                       \_\_\_\_\_                
                                                                                 

       Too low                          Color                                     
                      \_\_\_\_\_                       \_\_\_\_\_                
                                                                                 

       Not readily                      Shape                                     
  visible             \_\_\_\_\_                       \_\_\_\_\_                
                                                                                 

       Poor sign                                                                  
  spacing             \_\_\_\_\_                                                 
                                                                                 
  ------------------- ------------ ------------------- ------------ ------------ ------------

  --------------------- --------------- ---------------- -----------------
  **Overall Advance     Excellent       Adequate         Inadequate  
  Warning:**            \_\_\_\_\_      \_\_\_\_\_       \_\_\_\_\_   

  --------------------- --------------- ---------------- -----------------

> Comments:
>
>  
>
>  
>
> **CHANNELIZATION**

  ------------------- ------------ ------------ ------------ ------------------ ------------
  **Devices                                                                     
  Used/Condition:**                                                             

                      **Good**     **Fair**     **Poor**                         

       Barricades       \_\_\_\_\_   \_\_\_\_\_   \_\_\_\_\_ Unsafe ballasting    
                                                                                \_\_\_\_\_
                                                                                  

       Drums                                      \_\_\_\_\_ Unsafe battery       
                      \_\_\_\_\_   \_\_\_\_\_                mount              \_\_\_\_\_
                                                                                  

       Cones                                      \_\_\_\_\_ Inadequate spacing   
                      \_\_\_\_\_   \_\_\_\_\_                                   \_\_\_\_\_
                                                                                  

       Vertical                      \_\_\_\_\_   \_\_\_\_\_ Inadequate taper     
  panels              \_\_\_\_\_                             length             \_\_\_\_\_
                                                                                  

       Tubular          \_\_\_\_\_   \_\_\_\_\_              More devices         
  markers                                       \_\_\_\_\_   needed             \_\_\_\_\_
                                                                                  

       Warning lights                \_\_\_\_\_   \_\_\_\_\_ Non-standard         
                      \_\_\_\_\_                             device             \_\_\_\_\_
                                                                                  
  ------------------- ------------ ------------ ------------ ------------------ ------------

  --------------------- --------------- ---------------- -----------------
  **Overall             Excellent       Adequate         Inadequate  
  Channelization:**     \_\_\_\_\_      \_\_\_\_\_       \_\_\_\_\_   

  --------------------- --------------- ---------------- -----------------

> Comments:
>
>  
>
>  
>
> **PAVEMENT MARKINGS**

  ---------------- -------------- -------------- -------------- -----------------------
  **No markings**     \_\_\_\_\_  **Confusing       \_\_\_\_\_   
                                  markings**                    

  **Condition:**   **Good**       **Obscured**   **Faded**      **Damaged/Dislodged**

       Paint or       \_\_\_\_\_     \_\_\_\_\_     \_\_\_\_\_     \_\_\_\_\_   
  Tape                                                          

       Raised         \_\_\_\_\_     \_\_\_\_\_     \_\_\_\_\_     \_\_\_\_\_   
  Markers                                                       
  ---------------- -------------- -------------- -------------- -----------------------

  ----------------- ----------------- ----------------- -----------------
  **Overall         Excellent         Adequate          Inadequate   
  Markings:**       \_\_\_\_\_        \_\_\_\_\_        \_\_\_\_\_   

  ----------------- ----------------- ----------------- -----------------

> Comments:
>
>  
>
>  
>
> **FLAGGING**

  ------------------------ ----------------- ----------------- -----------------
  **Number/Effectiveness                     **Flagger          
  of Flaggers:**                             Signs:**          

       Effective              \_\_\_\_\_          Good            \_\_\_\_\_   
                                                               

       Ineffective            \_\_\_\_\_          Too close       \_\_\_\_\_   

       Poor coordination      \_\_\_\_\_          Too far         \_\_\_\_\_   

       Not enough flaggers    \_\_\_\_\_          No flagger      \_\_\_\_\_   

  **Flagging Technique:**                         No sign         \_\_\_\_\_   

       Good                   \_\_\_\_\_     **Signal             \_\_\_\_\_   
                                             Device:**         

       Fair                   \_\_\_\_\_          Flags           \_\_\_\_\_   

       Poor                   \_\_\_\_\_          Paddles         \_\_\_\_\_   

  **Flagger Attire:**         \_\_\_\_\_                        

       No hard hat            \_\_\_\_\_                        

       No vest                \_\_\_\_\_                        
  ------------------------ ----------------- ----------------- -----------------

  ----------------- ----------------- ----------------- -----------------
  **Overall         Excellent         Adequate          Inadequate   
  Flagging:**       \_\_\_\_\_        \_\_\_\_\_        \_\_\_\_\_   

  ----------------- ----------------- ----------------- -----------------

> Comments:
>
>  
>
>  
>
> **ROADSIDE SAFETY**
>
> **Type of Barrier**: Concrete    \_\_\_\_\_    Timber Curb   
> \_\_\_\_\_    Guiderail    \_\_\_\_\_    Other    \_\_\_\_\_   \
> **Barrier Condition**: Fair    \_\_\_\_\_    Poor    \_\_\_\_\_   \
> **Flared end treatment needed**    \_\_\_\_\_    **Impact attenuator
> needed**    \_\_\_\_\_   \
> **Barrier Delineation:**\
>      **Lights:** Good    \_\_\_\_\_    Fair    \_\_\_\_\_    Not
> working    \_\_\_\_\_   \
>      **Reflectors**: Good    \_\_\_\_\_    Fair    \_\_\_\_\_    Poor
>    \_\_\_\_\_    Too small    \_\_\_\_\_   \
>      **Inadequate drop-off delineation**    \_\_\_\_\_   \
> **Inadequate clear zone**    \_\_\_\_\_   \
> **Overall roadside safety**: Excellent    \_\_\_\_\_    Adequate   
> \_\_\_\_\_    Inadequate    \_\_\_\_\_   
>
> Comments:
>
>  
>
>  
>
> **MISCELLANEOUS TRAFFIC CONTROL**
>
> **Unprotected operations or equipment in roadway**    \_\_\_\_\_   \
> **Poor temporary traffic signal operation/installation**    \_\_\_\_\_
>   \
> **Original signs/delineation in poor condition**    \_\_\_\_\_   \
> **Speed limit:** \_\_\_\_\_ mph Too low    \_\_\_\_\_    Appropriate
>    \_\_\_\_\_   \
> **Pedestrian Safety:**\
>      **Inadequate travel path**    \_\_\_\_\_    **Inadequate
> protection from hazards**    \_\_\_\_\_   \
> **Access Control:** Good    \_\_\_\_\_    Fair    \_\_\_\_\_    Poor
>    \_\_\_\_\_   \
> **Overall Misc. Traffic Control:** Excellent    \_\_\_\_\_    Adequate
>    \_\_\_\_\_    Inadequate    \_\_\_\_\_   
>
> Comments:
>
>  
>
>  
>
> **OVERALL RATING    \_\_\_\_\_   **

## CONSTRUCTION PROJECT M&PT SURVEY RATING SYSTEM

  ----------------------------------- -----------------------------------
  5                                   Excellent design and implementation
                                      of M&PT. Controls provide adequate
                                      driver guidance for virtually all
                                      situations. No significant
                                      deficiencies encountered, and
                                      comments were limited to
                                      fine-tuning or other minor
                                      adjustment. All TCDs are in good
                                      condition, appropriate for the
                                      actual situation, and properly
                                      placed.

  4                                   Good design and implementation of
                                      M&PT. Controls provide adequate
                                      driver input for most situations
                                      likely to be encountered. Some
                                      minor deficiencies may be present,
                                      such as less than optimum choice,
                                      condition or placement of
                                      individual device.

  3                                   Design and implementation of M&PT
                                      is generally acceptable. There may
                                      be a number of specific points that
                                      can be improved or refined, and
                                      occasional points that may be only
                                      marginally effective.

  2                                   Design and implementation of M&PT
                                      is only marginally effective. Many
                                      specific points need refinement or
                                      adjustment, or a number of
                                      individual points are marginally
                                      effective. Although drivers
                                      familiar with the work zone can be
                                      expected to traverse it safely,
                                      unfamiliar drivers may experience
                                      difficulty, especially during
                                      adverse conditions, such as heavy
                                      traffic, rain, or darkness.

  1                                   Although some traffic controls have
                                      been provided, they are not
                                      adequate to provide guidance
                                      through the work zone. Drivers
                                      familiar with the site may not
                                      experience difficulty during
                                      favorable conditions, but
                                      unfamiliar drivers will probably
                                      have problems in traversing the
                                      site during all conditions, and
                                      even familiar drivers during
                                      adverse conditions.

  0                                   Other than occasional signs or
                                      other devices which are not
                                      coordinated or effective, no
                                      traffic control is provided, and
                                      motorists are left on their own to
                                      traverse the work zone. Guidance
                                      provided to drivers may be
                                      misleading such that drivers are
                                      directed to make inappropriate or
                                      dangerous responses.
  ----------------------------------- -----------------------------------

>