Yes No Are Equipment, Materials, or Other Items Blocking Sidewalk If yes, explain: Does the Pedestrian Route Maintain ADA Minimum 36” Width If no, explain: Deficiencies Found (Include location): If deficiencies were found, submit them to the and obtain Contractor’s Superintendent date & signature on this form. All deficiencies need to be corrected by: Date: Date: Contractor Superintendent’s Signature: INSPECTOR SIGNATURE: Date: cc: Regional Safety Coordinator
Yes No Are Equipment, Materials, or Other Items Blocking Sidewalk If yes, explain: Does the Pedestrian Route Maintain ADA Minimum 36” Width If no, explain: Deficiencies Found (Include location): If deficiencies were found, submit them to the Contractor’s Superintendent and obtain date & signature on this form. All deficiencies need to be corrected by: Date: Contractor Superintendent’s Signature: Date: INSPECTOR SIGNATURE: Date: cc: Regional Safety Coordinator
8-21_Workzone_Traffic_Control_Inspection_Form.docx