Structure Number:	Road Number:
Road Name:	Local Authority:
SLK:	Latitude:
Responsibility Area:	Longitude:
Inspected By:	Inspection Date:

Have structural issues been found that require further investigation? (Y/N)

Inspection Item	Defect	Comments (Including location and extent)	Maint. Required
Yes	No
1. Barriers Protection to gantry columns: are they present, accident damage, connections, alignment, material defects
2. Gantry Beams Main structural component spanning, or partially spanning (if cantilevered), the road and connections to the columns: material defects, impact damage, large deflections, corrosion, flexible sealant, coatings/paint
3. Gantry Columns Columns supporting the beam, Base Plates/Gussets: material defects, impact damage, buckling, corrosion, cracked welds, coatings/paint
4. Footings Gantry column foundations: visible; above or below ground? Concrete: material defects, cracking, spalling, movement or settlement
5. Anchor Bolts and Mortar Grout Pads Gantry column anchor bolts: visible; above or below ground? Bolts, Nuts, Washers: material defects, missing, corrosion, projection of thread Grout Fill: material defects, cracking or spalling
6. Maintenance Access Access ladder, access hatches, walkway, walkway balustrades: material defects, corrosion, missing seals, coatings/paint, locks
7. Static Signs Static signs, sign lights: material defects, corrosion, mounting brackets (welded, bolted, clipped, etc.), support angles, reflective paint, graffiti, general readability
8. Variable Message Signs (VMSs) Variable Message Signs: material defects, corrosion, mounting brackets (welded, bolted, clipped, etc.), support angles, exposed wires, graffiti, general readability

Defect Descriptions

Material	Defect Descriptions
Concrete	Cracking (hairline: ≤0.1mm) (fine: >0.1 & ≤0.3mm) (medium: >0.3mm & ≤0.7mm) (heavy: >0.7mm), spalling, corrosion of reinforcement, rust staining, honeycombing
Steel	Bending, buckling, cracking, distortion, corrosion, surface rust, pitting or flaking, protective coating damage/deterioration, loose fasteners
Timber	Splitting, crushing, rot, failure, termites/termite nest
Protective Coating	Cracked, weathered, peeling, flaking, oxidising

General Comments
Ancillary Items (such as service attachments, cameras etc.)

This sign gantry has been inspected in accordance with the requirements of the Main Roads Western Australia Sign Gantry Guidelines for Level 1 inspections.

Signature: _______________ Position: _________________	Date: __________