B.W. Sewermain - End of Maintenance Period Audit

• Document No.

• Project No.

• Project Name

• Site Details

• Conducted on

  Date

• Prepared by

• Drawings

• Date for end of maintenance period

  Date

• MH's

Checked MH

MH Checked

• MH No.

• A. Cover level with surrounding surface. No settlement.

  C

  NC

  NA
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• Reason for NC:

• B. No damage to cover or surround.

  C

  NC

  NA
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• Reason for NC:

• C. Cover & surround seal to MH chamber/taper intact.

  C

  NC

  NA
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• Reason for NC:

• D. No debris in channel and not holding water.

  C

  NC

  NA
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• Reason for NC:

• E. Is 3rd party damage or works likely to be the cause of any issues?

  Yes

  No

  Partial
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• Specific Comments:

• Comments.....

• Photos.....

  Media

• MS/TMS

Checked MS/TMS

MS/TMS Checked

• MS/TMS No.

• A. Cover stable & level with surrounding surface. No settlement.

  C

  NC

  NA
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• Reason for NC:

• B. No damage to cover or surround.

  C

  NC

  NA
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• Reason for NC:

• C. Distance from cover to top of screw cap between 100-150mm.

  C

  NC

  NA
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• Reason for NC:

• D. Shroud central, not damaged, no gap under cover.

  C

  NC

  NA
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• Reason for NC:

• E. Is 3rd party damage or works likely to be the cause of any issues?

  Yes

  No

  Partial
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• Specific Comments:

• Comments.....

• Photos.....

  Media

• Trench Settlement Observed?

  No

  Yes
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• Trench Settlement

Trench Settlement Observation

Trench Settlement Observation

• Observation Location?

• For this location what is the worst case depth of trench settlement (m)?

• For this location what is the approximate length of trench settlement (m)?

• Specific Comments.....

• Photos.....

  Media

• General Comments.....

Trench Reinstatement

• Trench reinstatement is satisfactory?

  C

  NC

  NA
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• Reason for NC:

• Photos:

  Media

Site Cleanup & demobilisation

• Site cleanup & demobilisation is complete?

  C

  NC

  NA
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• Reason for NC:

• Photos:

  Media

• Other Observations

Observation

Other Site Observation

• Comments.....

• Photos.....

  Media