Field survey checklist
What does this form include?
This form contains 9 sections:
1. Driving Observation: Does Driver...
- a. And all occupants wear seatbelts?
- b. Obey posted speed limits?
- c. Maintain adequate following distance?
- d. Slow down gradually when approaching red lights and stop signs?
- e. Make a full stop at all stop signs?
- f. Drive with caution in congested/construction zones?
- g. Avoid excessive and unnecessary lane changes?
- h. Blend smoothly with merging traffic?
- i. Have loads secured properly?
- j. Maintain proper speeds for conditions (i.e. rain, pulling trailer/load)
- k. Have trailer properly hooked up and tail lights operational?
- l. Utilize strobe lights upon entering/leaving worksite?
- Notes:
2. Boating Operations: Does operator/crew:
- a. Wear approved Life Vests at all times?
- b. Have Boat Inspection/Orientation filled out and on hand?
- c. Have all safety equipment on board?
- d. Operate boat safely and consistent with policies?
- e. Have current registration sticker and registration?
- f. Water or fluids on board?
- g. Load/Unload boat safely?
- h. Maintain attention to the surrounding and to FDOT Employees?
3. If Flagging Operation Observed: Does Crew...
- a. Maintain attention to oncoming traffic at all times?
- b. Utilize strobe lights on vehicle?
- c. Use proper lifting techniques for loading/unloading?
- d. Set up/pick up flagging operation in proper sequence?
- e. Have proper and valid certifications?
- f. Place temporary traffic control devices at proper spacing and according to specifications?
- g. Position flaggers properly?
- h. Stay behind positive protection when outside of vehicle and idle?
- i. Park vehicle behind position protection or as far from travel as possible?
- j. Utilize light towers for night flagging?
- k. Utilize reflective stop/slow for night flagging?
- l. Flag traffic correctly and efficiently?
- m. Have traffic properly and safely controlled?
- Notes:
4. If Lane Closure Operations Observed, Does Crew...
- a. Maintain attention to oncoming traffic at all times?
- b. Utilize strobe lights on vehicle?
- c. Utilize proper lifting techniques for loading/unloading?
- d. Set up/pick up lane closure operations in proper sequence?
- e. Place Temporary Traffic Control Devices at proper spacing and according to specifications?
- f. Stay behind positive protection when outside of vehicle and idle?
- g. Park vehicle behind positive protection or as far from travel lane as possible?
- h. Maintain cones upright?
- Notes:
5. If Light/Flag Service Operation Observed: Does Crew...
- a. Maintain attention to oncoming traffic at all times?
- b. Utilize strobe lights on vehicles?
- c. Utilize proper lifting techniques for loading/unloading?
- d. Perform service behind positive protection?
- e. Remove device away from travel lane before servicing?
- f. Utilize fall protection plan and CAZ when servicing lights accessible from the working surface of a bridge for lights on a leading edge?
- g. Use ladders safely and according to safety policy?
- h. Remove signs from the wall before servicing when located on a leading edge?
- i. Utilize PPE fall protection when servicing lights/flags on signs located on a leading edge?
- j. Park vehicle behind positive protection or as far from travel lane as possible?
- Notes:
6. If Delivery/Pickup Operation is Observed, Does Crew...
- a. Have load properly secured?
- b. Maintain attention to oncoming traffic at all times?
- c. Utilize strobe lights on vehicles?
- d. Use proper lifting techniques?
- e. Deliver/pick up proper equipment?
- f. Unload/load behind positive protection or a far from the travel lane as possible?
- g. Have trailer properly hooked up to vehicle?
- Notes:
7. If Sign Installation/Removal is Observed: Does Crew...
- a. Maintain attention to oncoming traffic at all times?
- b. Utilize strobe lights on vehicles?
- c. Utilize proper lifting techniques for loading/unloading?
- d. Install sign to proper FDOT offset from travel lane?
- e. Install sign according to plans and specifications?
- f. Pay attention to utility locates during installation?
- g. Excavate in a safe manner?
- h. Utilize PPE fall protection when installing signs on a leading edge?
- i. Park or work behind positive protection or as far from travel lane as possible?
- Notes:
8. If Installation/Repair or Removal of Attenuator is Observed, Does Crew...
- a. Maintain attention to oncoming traffic at all times?
- b. Utilize strobe lights on vehicle?
- c. Utilize proper lifting techniques for loading/unloading?
- d. Properly secure load?
- e. Utilize proper hoisting techniques?
- f. Utilize power tools with frayed or cut cords?
- g. Wear proper eye protection when drilling holes or grinding or cutting bolts?
- h. Utilize proper nuts/bolts/epoxy?
- i. Park truck and/or trailer between them and oncoming traffic?
- j. Maintain sage distance from objects that are hoisted?
- k. Utilizes additional safety measures (i.e. TMA, lane closure) if worksite is unsafe distance from travel lanes?
- l. Utilize proper respirator protection during drilling concrete if appropriate?
- Notes:
General Comments
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