• Work Order - Address.

  • Conducted on

  • Completed by

  • Location
  • Work to be done description

Repair details

  • Urgency of repair

  • Work to be completed description

  • Enter Suggested Repair Time Identify preferred repair time based on site assessment and conditions Eg: Any time from Monday to Friday (9am - 3:30pm) Saturday or Sunday morning (5am - 9pm)

Have Asset Locations Been Completed?

  • Have locations been completed?

Planning details

  • Shutoff required?

  • School in shutoff block?

  • Business in shutoff block?

  • Hospital in shutoff block?

  • Residential in shutoff block?

  • Number of valves in shutoff?

  • Additional resources required for shutoff?

  • Notification cards required?

  • Number of cards required?

  • Traffic control required?

  • Traffic control special details

  • Can the work be performed by:

  • Work details for 2 X 1 manners

  • Add photo

Work, Fittings and Road Reinstatement Details.

  • Will Bitumen Road Reinstatement be required

  • Bitumen Reinstatement length (M)

  • Bitumen Reinstatement Width (M)

  • Bitumen Reinstatement Depth (mm)

  • Fittings required for repair?

  • Welder required to perform on-site work?

  • Special requirements or instructions? Eg: shoring, hydro excavation, cold/hot mix, 2nd tipper, Dual axle Tipper

  • Add photo

  • Draw a sketch here

Asset Location Details.

  • Do you want to record locations details now?

  • Time arrived?

  • Time finished?

  • One Call centre - 1100 contacted for plans?

  • Other authorities contacted for plans?

  • Identify other authorities contacted for plans

  • Telstra located with sub-site unit?

  • Is Telstra asset close to excavation?

  • SA Power Networks located with sub-site unit?

  • Is SA Power Networks asset close to excavation?

  • Gas located with sub-site unit?

  • Is Gas asset close to excavation?

  • SA Water asset located with sub-site unit?

  • Is other Water/Wastewater asset close to excavation?

  • Trans SA located with sub-site unit?

  • Trans SA asset close to excavation?

  • Public lighting located with sub-site unit?

  • Is public lighting asset close to excavation?

  • Fibre optic cables located with sub-site unit?

  • Fibre optic cables close to excavation?

  • Have plans been attached/sent?

  • Other locate details? Specify below:

  • Has operations centre been notified to pass on any hazards workers may come across at this job site?

  • What details were given to operations centre to pass on?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.