Brisbane City Council - DA Engineering " Field Inspection Report"

• Document No.

• Audit Title

• Investigation Number

• Site Address

• Conducted on

  Date

• Prepared by

• Location
  Address

Elements

• Roads

• Stormwater

• Sewer

• Water

Results/Defects

• Roads acceptable?

  Yes

  No

  N/A

• Stormwater acceptable?

  Yes

  No

  N/A

• Sewer acceptable?

  Yes

  No

  N/A

• Water acceptable?

  Yes

  No

  N/A

Summary

• Inspection Type?

  On Maintenance

  Off Maintenance

• Pre-Start?

  Yes

  No

• Line test complete?

  Yes

  No

• Meters by contractor?

  Yes

  No

• Do you require written confirmation that work has been rectified?

  Yes

  No

• Accredited pipe layer's name

• Inspection Result

  Pass

  Fail

• Is a re inspection fee required?

  Yes

  No

  N/A

Consultant's Company Details

• Company Name

• Consultant's Name

• Phone

• Email

• Consultant's Signature

  Sign

Council Inspector's Details

• Council Inspector's Name

• Council Inspector's Signature

  Sign