CHEVRON TMP REQUEST FORM

What type of TMP Request are you submitting?
www.chevtraffic.co.nz | 0800 424 387 | PO Box 12520 Penrose, Auckland 1642

Start Date:

DayMonthYear
Date
Finish Date:

DayMonthYear
Date
Are these dates fixed?
e.g a planned shutdown
How many full days required:
Working Days Required:
Working Times Required:

Please note - The times that you have requested may vary due to an allowance for set up and pack of traffic control equipment.
DAY WORKS - Start Time:

Hour Minutes Minutes

AM/PM Option
Finish Time:

Hour Minutes Minutes

AM/PM Option
NIGHT WORKS - Start Time:

Hour Minutes Minutes

AM/PM Option
Finish Time:

Hour Minutes Minutes

AM/PM Option
NOTE:
General AT / RCA rules around working times:

Level 1 Rd:
DAY 07:00-17:00
NIGHT 19:00-06:00
Level 2 Rd:
DAY 09:00-16:00
NIGHT 21:00-05:00
ACTIVITY / WORKS:
Please note: To ensure a smooth application process with the Road Controlling Authority, please send through or upload on the next page any relevant Vehicle Crossing Permits, Building Consents, or other required authorizations. Providing these now allows us to include them in your initial TMP application and can result in a faster approval turnaround.
Site Address / Rd Name:
Activity Description:
Methodology:
Steps being taken each day e.g. detailed information of the work activity taking place daily.
Vehicles / Equipment / Personnel Required on-site:
Number and type / size
Excavation? Will there be any excavation during the project?
Workspace effects the:
Please provide more information on where the Workspace effects
Are there hazards left in place: Will you need after care?
Aftercare refers to the traffic controls and signage, required to keep a worksite safe when work is paused (overnight or over the weekend)
Do you think a FULL ROAD CLOSURE is required?
CONTRACTOR DETAILS:

Who is doing the work on-site.
Contact Name:
Contractor:
Contact Number:
Contact Email:
example@example.com
PRINCIPAL DETAILS:

Who is work being done for (e.g. Auckland Transport / property owner)
Contact Name:
Principal:
Contact Number:
Contact Email:
example@example.com
CHEVRON BILL PAYER:

Who will accept the charges from Chevron Traffic Services?
Bill Payer:
CHEVRON PO Number:

If your accounts team require PO numbers to process invoices - then you MUST provide a PO before we can process the TMP
PO Number:
AT BILL PAYER:

Who will accept the charges from the Road Controlling Authority for the application?
Bill Payer:
AT PO Number:

If your accounts team require PO numbers to process invoices - then you MUST provide a PO before we can process the TMP
PO Number:
www.chevtraffic.co.nz | 0800 424 387 | PO Box 12520 Penrose, Auckland 1642

TMP REQUEST FORM
PLEASE PROVIDE A MARKED IMAGE / SCREENSHOT OF THE WORK AREA REQUIRED SEE EXAMPLES BELOW

Cancelof
General TMP Check
PLEASE MARK UP ALL WORK AREAS REQUIRED
PARTICULARLY IF WORKS ARE ON BOTH SIDES OF THE ROAD
One side of the road only.
Both sides of the road.
Working across entire road.
www.chevtraffic.co.nz | 0800 424 387 | PO Box 12520 Penrose, Auckland 1642

EVENT REQUEST FORM
PLEASE PROVIDE A MARKED IMAGE / SCREENSHOT OR 'MUDMAP' OF THE WORK AREA REQUIRED FOR EVENT.

Cancelof
Event TMP Check
www.chevtraffic.co.nz | 0800 424 387 | PO Box 12520 Penrose, Auckland 1642

FILM REQUEST FORM
PLEASE PROVIDE A MARKED IMAGE / SCREENSHOT OR 'MUDMAP' OF THE WORK AREA REQUIRED FOR FILMING.

Cancelof
Film TMP Check
www.chevtraffic.co.nz | 0800 424 387 | PO Box 12520 Penrose, Auckland 1642

Please go back and review that the information filled is correct or Submit the application.
Requestor email
example@example.com
I acknowledge that my TMP will not be submitted to the local RCA until I have reviewed and approved the draft, this will be sent to the email provided.
www.chevtraffic.co.nz | 0800 424 387 | PO Box 12520 Penrose, Auckland 1642
Should be Empty:

ACTIVITY / WORKS:

CONTRACTOR DETAILS:

PRINCIPAL DETAILS:

CHEVRON BILL PAYER:

CHEVRON PO Number:

AT BILL PAYER:

AT PO Number:

TMP REQUEST FORM

ACTIVITY / WORKS:

LOCATION MANAGER / CONTRACTOR DETAILS:

EVENT COMPANY / PRINCIPAL DETAILS:

BILL PAYER:

Reference / PO Number:

AT BILL PAYER:

EVENT REQUEST FORM

ACTIVITY / WORKS:

LOCATION MANAGER / CONTRACTOR DETAILS:

FILM COMPANY / PRINCIPAL DETAILS:

BILL PAYER:

Reference / PO Number:

AT BILL PAYER:

FILM REQUEST FORM

Please go back and review that the information filled is correct or Submit the application.