A55 report

• A55 number ( must be same as on updated sld ) number and initials ie..... 0.15jp

• Conducted on

  Date

• Prepared by

• Location
  Address

• contract / piano number

• Ref number including initials

• location
  Address

• Date

  Date

• Engineer completing a55

• Contact number

Blockage details.

• Are other options available. ( re route , overhead )

  Yes

  No

  N/A

• Alternative details

• can minimal footway clearance be maintained of 1.2m

  Yes

  No

  N/A

• Address of point A , including meters tested before blockage.

• Photo of point A with rod in duct

  Media

• Address of point b including meters tested back to point a

• photo of point B including rod in duct

  Media

• Additional notes on blockage . road speed ,tm, no mans land . please add report here.

• Additional photos here with regards to blockage .

  Media

• Three little words on blockage

  Yes

  No

  N/A

• Yes

  No

  N/A