B.W. Sewermain Construction Checklist

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Water Authority Validation Officer present?

  Yes

  No
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• Personnel

Site overview

• Inspection carried out the following time

• Select date

  Date

• Principal Contractor

• Sewer Contractor

• Number of workers on site

• Weather

  Fine

  Overcast

  Raining

• Site conditions

  Dry

  Dry / Dusty

  Wet

  Wet / Saturated

• Additional site conditions:

• All actions from previous inspection report completed

  Yes

  No

  N/A

Trench/Surface Restoration

• Was trench restoration inspected?

  Yes

  No
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• Have private properties given acceptance

  Yes

  No

  N/A

• Sewer has adequate protection from heavy machinery

  Yes

  No

  N/A

• All disturbed surfaces have been reinstated

  Yes

  No

  N/A

Maintenance Holes

• MH internals inspected?

  Yes

  No
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• Chases are free of ponding

  Yes

  No

  N/A

• Channels are smooth & well formed - No corners/correct radius

  Yes

  No

  N/A

• Pipes do not protrude into chase

  Yes

  No

  N/A

• Is dummy chase required/provided

  Yes

  No

  N/A

• Drops meet specification & have minimum of 1 bracket & 60° bend at bottom

  Yes

  No

  N/A

• M/H's over 6m have ladders and landings

  Yes

  No

  N/A

• Ladders have holdfasts spaced 1500 maximum

  Yes

  No

  N/A

• Top Step of Ladder is maximum 600 from surface

  Yes

  No

  N/A

• Bottom step of Ladder is maximum 325 minimum 200 from base

  Yes

  No

  N/A

Drop Structures

• Were drop structures inspected?

  Yes

  No
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• Drops are vertical

  Yes

  No

  N/A

• Drops have correct table design (directed to outlet without bends)

  Yes

  No

  N/A

• Drops have concrete filled behind structure and is smooth and draining into chase

  Yes

  No

  N/A

• Drops are positioned correctly and structurally sound

  Yes

  No

  N/A

• Drops greater than 1200 have a second bracket

  Yes

  No

  N/A

Sewer Lines

• Pipeline construction inspected?

  Yes

  No
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• Correct pipe class/in date

  Yes

  No

  N/A

• Bedding Material is approved

  Yes

  No

  N/A

• Bedding depth is adequate

  Yes

  No

  N/A

• Backfill material meets requirements

  Yes

  No

  N/A

• Jointing meets requirements

  Yes

  No

  N/A

• Sewer main has adequate clearances from other services

  Yes

  No

  N/A

• Is trench excavation adequate and clean (no rocks, clean edges)

  Yes

  No

  N/A

• No cut in's on curved lines

  Yes

  No

  N/A

• Lines are free of infiltration & other visable faults

  Yes

  No

  N/A

• Isolation plugs & platforms have all been removed

  Yes

  No

  N/A

Sewer Management

• Contractor has Project Management Plan onsite and up to date

  Yes

  No

  N/A

• Contractor has Safe Work Method Statement (SWMS) on site and up to date

  Yes

  No

  N/A

• Contractor has Inspection Test Plan on site and up to date

  Yes

  No

  N/A

• Contractor has Tool Box meeting minutes on site and up to date

  Yes

  No

  N/A

• Contractor has Site Induction requirements and documentation on site and up to date

  Yes

  No

  N/A

• Contractor has Approved up to date construction plan on site

  Yes

  No

  N/A

• Contractor has One call documentation on site and up to date

  Yes

  No

  N/A

• Nominated supervisor on site

  Yes

  No

  N/A

O.H.S Checks

• Red card

  Yes

  No

  N/A

• Correct PPE Hats, Vests

  Yes

  No

  N/A

• Isolation of live sewer

  Yes

  No

  N/A

• Barricading

  Yes

  No

  N/A

• First aid

  Yes

  No

  N/A

• Power

  Yes

  No

  N/A

• Water

  Yes

  No

  N/A

• Toilets

  Yes

  No

  N/A

• General safety

  Safe

  At Risk

  N/A

Traffic control

• Is traffic control required?

  Yes

  No
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• Workmen ahead signage

  Yes

  No

  N/A

• Detour ahead signage

  Yes

  No

  N/A

• Arrow boards

  Yes

  No

  N/A

• Road closed signage

  Yes

  No

  N/A

• Is traffic management in place

  Yes

  No

  N/A

• Is VicRoads approval required and received

  Yes

  No

  N/A

• Are bollards being used in a responsible manner

  Yes

  No

  N/A

• Is pedestrian access in place

  Yes

  No

  N/A

Excavations / Trenching

• Are there any excavation works

  Yes

  No
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• Is trenching / excavation > 1.5m deep

  Yes

  No

• Edge protection & ladder access in place

  Yes

  No

  N/A

• Are shields being used

  Yes

  No

  N/A

• Is benching being used

  Yes

  No

  N/A

• Are road plates required and available

  Yes

  No

  N/A

• Are road plates in use

  Yes

  No

  N/A

• Is there a "Mine Mangers" certificate holder on site

  Yes

  No

  N/A

• Is spoil away from edge of trench

  Yes

  No

  N/A

• Are the trenches backfilled if no more work is required

  Yes

  No

  N/A

• Is barricading suitable

  Yes

  No

  N/A

• Has allowance for underground services and protection been made

  Yes

  No

  N/A

Confined Spaces

• Is confined space entry required

  Yes

  No
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• Has permit to work been obtained

  Yes

  No

  N/A

• Is entry to a confined space required

  Yes

  No

  N/A

• Is signage in place

  Yes

  No

  N/A

• Do personnel have confined space entry ticket

  Yes

  No

  N/A

• Is breathing apparatus in use

  Yes

  No

  N/A

• Correct PPE used and in date?

  Yes

  No

  N/A

• Pits > 1.5 required for assessment

  Yes

  No

  N/A

• Is the SWIFT Form Q current for Sewer applications

  Yes

  No

  N/A

Materials

• Delivery / Handling / Storage

  Satisfactory

  Un-satisfactory

Temporary bench marks

• Marked and maintained

  Yes

  No

Machinery

• Is machinery in use

  Yes

  No
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• Does plant have flashing lights that are working and being used

  Yes

  No

  N/A

• Does plant have reversing beepers

  Yes

  No

  N/A

• Does plant have roll over cages / protection where required

  Yes

  No

  N/A

• Has provision for O/H services been allowed for

  Yes

  No

  N/A

Summary

• Safety Advisors Comments

• Photo Records:

  Media

• Safety Advisor

  Sign

• Site Representative

  Sign

• I confirm that all actions highlighted within this report have been completed