Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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In use
VERIFICATION CHECKLIST
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In use
Test results
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Attached to checklist
NON-CONFORMANCE
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Identified by Contractor
NON-CONFORMANCE REPORT
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Submitted
SERVICES
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Identified and protected
MATERIALS Clause R 33.2
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Pipe type and class
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Pipe dia 100mm
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Filter material maximum size 19mm
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Geotextile class C
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Flush point pipe dia > 50mm
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Drain markers yellow triangular plates
TRENCH EXCAVATION Clause R 33.3.1
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Location correct
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Width 300mm
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Minimum depth 500mm below formation
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Minimum grade 1%
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Rock encountered
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Rock volume measured
INSTALLATION Clause R 33.3
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Pipe on 50mm bed of filter material
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Pipe deviation <40mm line and grade
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Top of pipe 100mm below sub base
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Geotextile lap 250mm on top
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Geotextile lap 500mm at joins
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Compaction method filter material as per CMP
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Connection to pits etc.
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End wall construction
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Pipe surround grouted to endwall
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Dead end capped
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Flush points at 120m maximum intervals
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Flush point demonstration of compliance
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Drainage markers at all locations
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Lemon yellow markers in Rock cuttings
NON-CONFORMANCE
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Identified in audit
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Report requested.
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Signature