Form SHA-52, also known as the "Application for Social Security Benefits," is a form used to apply for social security benefits. The form can be completed online or through a paper application. The form asks for personal information, such as your name, address, and social security number. It also asks about your work history and any disabilities you may have. Completing the form accurately is important, as it will determine your eligibility for social security benefits.
| Question | Answer |
|---|---|
| Form Name | Form Sha 52 4 01 |
| Form Length | 7 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min 45 sec |
| Other names | 14AppETTCInspec tionFormmasterc opyRev2 temporary traffic control inspection form pdf |
Temporary Traffic Control (TTC) Inspection ForM
Project Information
Rating/Grade of Project
District/County
Contractor Name
Project Location
Appropriate WZTC Standard
Inspection Checklist
TTC DEVICES
TEMPORARY BARRIER/CRASH CUSHION _____
ARROW PANEL _____
SIGNS _____
PAVEMENT MARKINGS/ RPMs _____
CHANNELIZING DEVICES _____
(Tubular Markers, Drums, Barricades, Cones, etc.)
FLAGGER _____
PORTABLE VARIABLE MESSAGE SIGN (PVMS) _____
Ratings Comments
Inspected By:
Date/Time of Inspection:
Permit/Contract No.
Project Eng./Foreman
Project Description
TTC OPERATIONS
WORK ZONE IMPACT _____
INTELLIGENT TRANSPORTATION SYSTEMS (ITS) APPLICATIONS _____
TRAFFIC OPERATIONS STRATEGIES _____
SAFETY _____
ACCIDENTS _____
GENERAL
CONTRACTOR IS CONFORMING TO CONTRACTUAL DOCUMENTS _____
*See reverse side for guidelines
Corrective Actions |
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Distribution |
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Corrective actions by: |
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At Request |
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Urgent (24 hrs) |
cc: ___ |
___ Utility Engineer |
___ District Engineer |
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5 Days |
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Spec Book |
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___ TDSD/OOTS |
___ Project Engineer |
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Additional information/ photographs attached |
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Yes |
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No |
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___ Other |
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SHA
Temporary Traffic Control (TTC) Devices
TTC Operations
TEMPORARY BARRIER/CRASH CUSHIONS
→Improper barrier wall flare
→Improper barrier end treatment
→Improper temporary barrier end transition with existing
→
→Reflector maintenance needed
→Reflector on barrier flare not allowed
→Barrier wall damaged or dirty
→Barrier delineation improper
→Inadequate or no crash cushion
→Improper installation of crash cushions
→Crash cushions damaged or dirty
ARROW PANEL
→None or
→Malfunction
→Incorrect placement
→Incorrectly aimed (or misaligned bulbs)
→Not dimmed at night
→Not protected as in SHA standard
→Inadequate sight distance
→Wrong indication/display
SIGNS
→SHA’s typical or TCP (for the current phase of job) not followed
→
→Poor reflectivity
→Conflicting permanent & temporary signing
→Sign legend problem
→Duct tape, obstructed, damaged, dirty, overlay plate,
→Wrong message
→Inappropriate/ contradictory signs not covered/removed
→Sign support problem
→Sign missing or down
→Horizontal and vertical clearances
PAVEMENT MARKINGS
→None or
→Less than full complement of pavement markings/ delineation
→Unnecessary or conflicting markings not obliterated completely
→Failing of temporary markings/Raised Pavement Markers (RPMs)
→Less than required number of RPMs
→Improper alignment
→Incorrect skip size/space
CHANNELIZING DEVICES (CDs) (CONES, DRUMS, ETC.)
→
→
→Incorrect spacing
→Placed too far away from traffic (> 2 ft.)
→Damaged, dirty or
→Improper alignment
→No CDs placed preceding barrier end sections
→Improperly weighted
→Missing or poor reflectivity
FLAGGERS
→
→STOP/SLOW paddle is
→Incorrect signaling device (flag)
→Incorrect flagging
→Wearing improper clothing
→No flaggers present (signs displayed)
→Improper distance from advanced warning sign to flagger
PORTABLE VARIABLE MESSAGE SIGNS
→Application does not meet SHA guidelines
→Incorrect or unapproved message
→
→Not protected as in SHA standard
→Improper placement
→Inadequate sight distance
→Too many messages
GENERAL
→Traffic Control Device is not
→Listed as an SHA “Approved Product”
→Lane closures do not have
→Improper stopping or detouring of traffic
→Unprotected hazards on or adjacent to travel roadway
→Pavement
→Missing or
WORK ZONE IMPACT
Visible problems/conflicts
→Excessive Queues/Delays
→High Speeds/Sudden Speed Changes
→Pedestrian/Bicycle Issues
→Business/Residential Impacts
→Limited Sight Distance
→Coordination w/ Adjacent Work Zones
→Reduced Ramp Merge Area/Ramp Queues
INTELLIGENT TRANSPORTATION SYSTEMS (ITS) APPLICATIONS
Not operating as intended/conveying inaccurate information/message not readable
→Speed Display
→Queue Detection System
→Dynamic Late Merge System
→Travel Time Estimation System
→Advanced Speed Information System
→Utilization of PCMS/Overhead DMS signs
TRAFFIC OPERATIONS STRATEGIES
Not operating as intended
→Lane Closure Restrictions
→Transit Service Operations
→Signal Timing Operations/Coordination
→Temporary Traffic Signal Operations
→Equipment Storage/Parking Issues
SAFETY
Visible need for/incorrect usage/location of
→Protection Vehicle
→Maryland State Trooper
ACCIDENTS
Evidence/reports of accidents
→Rear End
→Sideswipe
→Turning
→
→Head On
→Fixed Object
Note: Include any suggested applications/strategies that may be applicable for the work zone.
SHA
04/10/09 Page 1 of 5
TEMPORARY TRAFFIC CONTROL INSPECTION RATING SYSTEM
RATING “A”
The Inspector has rated the work zone as an “A” based on the actual traffic control meeting the following criteria:
−All traffic control devices are properly installed and maintained in accordance with the approved and applicable Traffic Control Plan, SHA Standards, Specifications, and/or Permits.
−Positive guidance is provided by delineating a clear, unmistakable, route for drivers and pedestrians utilizing approved signs, markings, and delineation.
−Lane closures are installed only at the prescribed times, are performed safely and efficiently, and create a minimal amount of disruption to traffic flow by assuring that the number and duration of lane closures is only as needed.
−Those responsible for the temporary traffic control installation/removal (i.e. Traffic Managers) or those responsible for regulating one lane,
−The project needs little or no further attention at this time.
−By employing the use of the “+” and
04/10/09 Page 2 of 5
TEMPORARY TRAFFIC CONTROL INSPECTION RATING SYSTEM
RATING “B”
The Inspector has rated the work zone as a “B” based on the actual traffic control meeting the following criteria:
−Traffic control devices are installed and maintained in accordance with the approved and applicable Traffic Control Plan, SHA Standards, Specifications, and/or Permits, with the exception of the need for corrections as noted on the Temporary Traffic Control Inspection/Rating Report.
−Positive guidance is provided with the need for corrections as noted on the Temporary Traffic Control Inspection/Rating Report.
−Monitoring and maintenance of Traffic Control Devices is performed at regular intervals, appropriate to the location and type of work zone setup.
−Lane closures are installed at the prescribed times, are performed safely and efficiently, and create a minimal amount of disruption to traffic flow, by assuring that the number and duration of lane closures is only as needed.
−Approved modifications are required to bring the work zone in compliance with the Traffic Control Plan, SHA Standards, Specifications, and/or Permits.
−Those responsible for the temporary traffic control installation/removal (i.e. Traffic Managers) or those responsible for regulating one lane,
−If corrective actions are not performed within timeframes outlined on the Temporary Traffic Control Inspection/Rating Report, then a rating of “C” or lower will be given.
−By employing the use of the “+” and
04/10/09 Page 3 of 5
TEMPORARY TRAFFIC CONTROL INSPECTION RATING SYSTEM
RATING “C”
The Inspector has rated the work zone as a “C” based on the actual traffic control meeting the following criteria:
−Traffic control devices are not installed and maintained in accordance with the approved and applicable Traffic Control Plan, SHA Standards, Specifications, and/or Permits and corrective actions are required as noted on the Temporary Traffic Control Inspection/Rating Report.
−Positive guidance is not provided and there is a need for corrections as noted on the Temporary Traffic Control Inspection/Rating Report.
−Monitoring of the temporary traffic control zone, by the Inspector and at the request of the Administration, is necessary to ensure compliance with the Traffic Control Plan, SHA Standards, Specifications, and/or Permits.
−Traffic safety and flow are maintained, but is reduced due to
−Those responsible for the temporary traffic control installation/removal (i.e. Traffic Managers) or those responsible for regulating one lane,
−If corrective actions are not performed within timeframes outlined on the Temporary Traffic Control Inspection/Rating Report, then a rating of “D” or lower will be given.
−By employing the use of the “+” and
04/10/09 Page 4 of 5
TEMPORARY TRAFFIC CONTROL INSPECTION RATING SYSTEM
RATING “D”
The Inspector has rated the work zone as a “D” based on the actual traffic control meeting the following criteria:
−Traffic control devices are not installed and maintained correctly in accordance with the approved and applicable Traffic Control Plan, SHA Standards, Specifications, and/or Permits. Corrective actions are necessary, as noted on the Temporary Traffic Control Inspection/Rating Report.
−Positive guidance is not provided and corrections are necessary, as noted on the Temporary Traffic Control Inspection/Rating Report.
−Those responsible for monitoring the temporary traffic control only do so regularly when mandated by the Administration.
−Unsafe conditions for drivers, workers, and pedestrians exist as a result of temporary traffic control
−Those responsible for the temporary traffic control installation/removal (i.e. Traffic Managers) or those responsible for regulating one lane,
−If corrective actions are not performed within timeframes outlined on the Temporary Traffic Control Inspection/Rating Report, then a rating of “F” will be given.
−Action will be taken, up to and including project shutdown, if corrective actions in accordance with the Temporary Traffic Control Inspection/Rating Report are not performed.
−In cases of project shutdown, those responsible for the temporary traffic control must ensure that the roadway is restored to a condition where safe traffic flow exists, prior to cessation of work activity.
−By employing the use of the “+” and
04/10/09 Page 5 of 5
TEMPORARY TRAFFIC CONTROL INSPECTION RATING SYSTEM
RATING “F”
The Inspector has rated the work zone as an “F” based on the actual traffic control meeting the following criteria:
−Traffic control devices are not installed and maintained correctly in accordance with the approved and applicable Traffic Control Plan, SHA Standards, Specifications, and/or Permits. Corrective actions are necessary, as noted on the Temporary Traffic Control Inspection/Rating Report.
−Positive guidance is not provided and corrections are necessary, as noted on the Temporary Traffic Control Inspection/Rating Report.
−Monitoring and maintenance/replacement of temporary traffic control devices is not being performed.
−Unsafe conditions for drivers, workers, and pedestrians exist as a result of temporary traffic control
−Immediate action will be taken against those responsible for the temporary traffic control and the entire project will be shut down.
−If those responsible for the temporary traffic control installation/removal (i.e. Traffic Managers) or those responsible for regulating one lane,
−In cases of project shutdown, those responsible for the temporary traffic control must ensure that the roadway is restored to a condition where safe traffic flow exists prior to cessation of work activity.
−Authorization from the appropriate SHA Division must be given before work can resume if the project has been shut down.