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YELLOW TIME CONFIRMATION FORM |
Version V2.4.1 |
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Contact: |
Robert Priest |
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Position: |
Vic Roads / DJR Liaison
Officer |
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Phone: |
9881 8721 |
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Email: |
Robert.Priest@roads.vic.gov.au |
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BA file No.: |
CS / 910 / DOJ / 016 |
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VR Re. No.: |
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(Allocated by Liaison
Officer) |
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……………….. |
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To: |
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Manager, Camera
Compliance, Research & Development |
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Infringement Management
& Enforcement Services (IMES) |
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Department of Justice
and Regulation (DJR) |
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From: |
Department of Justice
and Regulation Liaison Officer |
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VicRoads (VR) |
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Traffic Signal Details |
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1. Location and Site Details: |
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● Intersection: |
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● VicRoads Site No.: |
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● DJR Road Safety Camera Site No ('s) |
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( Can be obtained from
Safety Camera Site List, Quick Docs Ref No. 3490759) |
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Purpose of Check |
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2. Signal Operation Check Instigated because
of: |
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Speed change from ……..…….. to
……..……… on …………….……..
approach |
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……..……..
to ……..……… on
…………….…….. approach |
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Traffic Signal Controller replacement |
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Intersection Remodel (hardware and phasing
changes including LED upgrade) |
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New Road Safety Camera Installation |
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DJR request check of specific site |
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Other (Please Specify) |
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Yellow Time Confirmation Check |
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3. Confirmation Check |
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This site has been
checked for 'Yellow Time' compliance in accordance with current guideline for |
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all approaches to the
Intersection state above. |
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Safety Camera approach
speed confirmation. |
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Located on Road |
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approach |
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speed |
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Checked By: |
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Date: ….... / …….
/ ……………… |
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VicRoads |
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(Manager Signal
Services. Print name and signature required) |
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DJR Received: |
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Date: ….... / …….
/ ……………… |
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Document |
(Print name and
signiture required. Email back to VicRoads Liaison Officer) |
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DJR Reference No.: |
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DJR Comments
attached Yes /
No (For
DJR offical use only) |
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Document No.: 1724846
Yellow Time Confirmation Form |
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