HomeMy WebLinkAboutTCS - 2/15/2017 �_ Washington State Contractor's Daily Report of
VI/ Department of Transportation p Traffic Control - Summary
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'03853 709.3-TCS 02/15/2017"
Page One
Co tr ct Number SR Number Day Date
f
Photos /Videos taken today for record? ❑Yes ;ZliD-
If Yes, note locations:
61
3
Summary of T-CS Activities
5
Contr to Contr or' Tra Control S ervisor's Oignature
Comments
To be Completed by Contractors Traffic Control Supervisor(TCS)
DoT Form 421-040A EF Distribution: White-Contractor:Canary-Project Engineer
Revised 412004
M-I/ Washeviton State Contractor's Daily Report of Traffic
°eparcment of hallw4pe stion Control - Traffic Control Log
Use separate sheets for each setup. (May be altered to record Class A signs.) Page
Co tract Number SR Number Day Date
II _ I
Sta A Setup Sta B Legend
Station — Time Station — Time (List of Signs Used)
5
O 93 <3> O&ft-
56 i
rQh
LAS 0
— — Cones Piloted
O b `Y E]No ❑ Yes
5°�( i?�� — Per Approved Plan
S PP Plan Title
50'ul- PLYZ El No
Sta G T One Way Traffic Flagger/SpotterSta Start End Hours
I (one or more lanes) Sta D Station A
Two Way Traffic Station B
(two or more lanes) Station C
Sta on D
Other Traffic Control Labor
Name Start End Hours
4 ontr ct
Con ra or' raffic Control Supervisor's Signature
Type of Traffic Control Time Set Up Time(s)Checked Time Removed
IU S
To be Completed by Contractor's Traffic Control Supervisor(TCS)
DOT Form 421-0408 EF Distribution: White-Contractor;Canary-Project Engineer
Revised 032008 -