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Traffic Control Safety ChecklistWorksheet

By Amber Harper,2014-08-09 18:17
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Traffic Control Safety Checklist/Worksheet Location: _______________________________________ Date: __________________ Incident #: ________________ Incident Commander: __________________________________ Safety Officer: ________________________________ Vehicles on Scene: ________________________________________________________________________..

     Traffic Control Safety Checklist/Worksheet

    Location: _______________________________________ Date: __________________ Incident #: ________________ Incident Commander: __________________________________ Safety Officer: ________________________________ Vehicles on Scene: _________________________________________________________________________________ Type of Incident: ___________________________________________________________________________________ Estimated Time On Scene: Less than 20 minutes 20 60 minutes More than 60 Minutes

    Time of Day: _______________ Type of Roadway: _____________________________ Posted Speed Limit: ________ Weather Conditions: ___________________________________ Light Conditions: ______________________________ Traffic Conditions: Low Moderate Heavy

Initial Traffic Control (Less than 60 minutes) ; Completed

    Work area evaluated for hazards

    Emergency vehicle positioned properly

    Safety vests WORN

    Advanced warning sign (1) placed (100’ – 1000’)

    Traffic cones placed for taper (max of 20’ intervals) (100’ length)

    Traffic cones placed along work area (max of 40’ intervals)

    Emergency warning lights reduced

    Law enforcement notified

    Staging area established

    Incident terminated - cones/signs removed

Set-Up (Initial) Equipment Needed: Traffic cones (12), Emergency scene sign (1), Class 2 safety vest (2), Road flares (10)

    Advanced Warning Area: Distance ______________________ # of Signs ______________________

    Transition Area (taper): Distance ______________________ # of Cones _____________________

    Work Area: Distance ______________________ # of Cones _____________________

Temporary Traffic Control (More than 60 minutes) ; Completed

    Work area evaluated for hazards

    Emergency vehicle positioned properly

    Safety vests WORN

    Advanced warning signs (2) placed (100’ - 1500’)

    Transition area (taper) established (Cones max of 20’ intervals) (max 100’ length)

    Buffer space established

    Work area established

    Termination area established (Downstream taper) (max of 100’ per lane)

    Flaggers with equipment positioned properly

    Emergency air siren cans issued

    Portable radios issued

    Emergency warning lights reduced

    Law enforcement traffic control points established

    Local department of transportation on scene with advanced warning signs in place

    Staging area established

    Incident terminated - cones/signs removed

    Set-Up (Temp.) Equipment Needed: Traffic cones (25-50), Emergency scene sign (2), Flagger signs (2), Stop/slow

     paddles (2), Emergency air siren cans (3), Portable radios (3), Class 2 safety vest (4), Road flares (1 case)

    Advanced Warning Area: Distance __________ # of Signs ____________ # of Flaggers _____________

    Transition Area (taper): Distance __________ # of Cones

    Buffer Area: Distance __________ # of Cones

    Work Area: Distance __________ # of Cones

    Termination Area: Distance __________ # of Cones

     Drawing

Miscellaneous Information

    1. One advanced warning sign Urban (Low speed) 100’, Urban (High speed) – 350’, Rural – 500’,

     Expressways/Freeways 1000’

    2. Second advanced warning sign Urban (Low speed) 100’, Urban (High speed) – 350’, Rural – 500’,

     Expressways/Freeways 1500’

    3. Buffer area 30 MPH 625, 40 MPH 825, 50 MPH 1000’, 60 MPH – 1300, 70 MPH 1450 4. One lane taper 100 max. cone placement 10’ – 20

    5. Downstream taper 100per lane cone placement 10’ – 20

    6. The equipment listed is the minimum required. Additional safety vests may be required based on the

     number of personnel on the scene

    For additional information check with your State Department of Transportation and the Federal Highway Administration’s Manual on Uniform Traffic Control Devices, Millennium Edition, http//mutcd.fhwa.dot.gov.

    C10:213 (Rev. 4/03)

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