Nzgttm

Please upload any documents and Evidence using the upload button at the bottom of the page.

1.1. Risk Assessment Information

1.1.1. Supplementary Risk Assessment Documentation

Is there a supplementary risk assessment associated with this TMP (and attached)* *If yes, move on to section 1.2 *

Yes
No

If Option 1.1.1 (a supplementary attached risk assessment) is not selected, table 1.1.2 must be compiled

1.1.2. Identified Risks and Controls

1.1.2. Risk- Provide a detailed explanation of each risk that is relevant to the development of this TMP. Listed risks must subsequently match those listed in parts 2 and 3 of this TMP *

1.1.2. Associated control- Provide a description of the controls applied to the listed risk. Including the level in the hierarchy of controls that the control fits within *

Commentary on Selection

(in accordance with Hierarchy of Controls)

1.1.2. Provide an explanation regarding the choice of controls, what others might have been considered and discounted, and why the chosen control/s are the best available in accordance with the hierarchy of controls. *

1.2. Authorisations

1.2.2. Authorised Parking- Alterations to controlled street parking have been approved and evidence is attached *

Yes
No

1.2.2. Permanent Traffic Signals- Impacts on permanent traffic signals has been approved and evidence is attached *

Yes
No

1.2.3. Road Closure Authorisation- Where all vehicular traffic to a road is prohibited advertising and/or notification requirements are attached *

Yes
No

1.2.4. Public Transport Impacts- Public transport impacts have been approved and evidence is attached *

Yes
No

1.2.5. Portable Traffic Signals- Proposed make/model is Waka Kotahi approved for use *

Yes
No

1.2.6. Over Dimensional Route Impact- Evidence of notification for OD route (such as RCA and/or Heavy Haulage association) *

Yes
No

1.2.7. Rail Corridor Impact- Evidence of rail corridor interface approval is attached *

Yes
No

1.2.8 Temporary Road Safety Barrier Systems

1.2.8. Evidence of installation designer* qualifications attached *

Yes
No

1.2.8. Evidence of independent reviewer** experience attached *

Yes
No

*Installation Designer role is defined in AS/NZS 3845 Part 1:2015 section 1.5.1 (e). “Qualified” indicates Waka Kotahi Temporary Barrier Design Qualification (or ASHTAS equivalent)

**Independent Reviewer may be a qualified Installation Designer or other suitably qualified person

1.2.9. Additional Supporting Information: List any further supporting information or attachments included as part of this TMP planning form, or type None *

1.3 Delay Calculation Information-

Provide supplementary delay calculation information or logic to support outputs described in the Onsite Form

[Further detailed delay calculation information should be included here to validate the TTM methodology (this information is not required by the STMS on-site). If attachments (such as TIAs) are required, these should be referenced accordingly.] *

1.4. RCA Notification Prior to occupying worksite- Describe the notification procedure to be used *

1.5 Associated TMP Forms- Provide details of the number and titles of associated TMD forms with this planning form

1.5. TMD Number *

1.5. TMD Title *

1.5. No. of Diagrams *

Name: *

Date: *

1. TMP Planning Form

This form is used to provide supplementary information to approvers and reviewers as well as other impacted PCBUs. Any information provided in this TMP Planning Form must be consistent (and read in conjunction) with the associated General TMP form and TMD form/s.

1.1. Risk Assessment Information