C&RT/Kier Culvert Inspection Pre Survey Report

C&RT Culvert Clean & Inspection Contract

• Conducted on

  Date

• OnSite Project Number

• Culvert Name / Number

• Functional Location

• Waterway?

• Region

  Select East Midlands London Manchester & Pennine North East North West South East West Midlands North Wales & Borders Central Shires other

  • East Midlands
  • London
  • Manchester & Pennine
  • North East
  • North West
  • South East
  • West Midlands
  • North Wales & Borders
  • Central Shires
  • other

• Please name other region.

• Prepared by

• Grid reference / Postcode

• GPS location
  Address

• Type of works

  Select Straight CCTV CCTV Pumping CCTV, Pumping and Cleaning Other

  • Straight CCTV
  • CCTV Pumping
  • CCTV, Pumping and Cleaning
  • Other

• If other, please state.

• Access to a Confined Space

  Required

  Not Required

• Silt sample taken?

  Yes

  No

• If no, please state why (e.g. no cleaning is required, Water level too high etc.)

• Number of men required for task

• Primary Route of Access

  Landowner

  Towpath

  Public

  Highways

  Private

Culvert inlet

• Inlet found?

  Yes

  No

• Photo of Inlet structure

  Media

• Comments

• Photo of Watercourse upstream from inlet

  Media

• Comments

• Photograph of culvert internal

  Media

• Comments

• Height (mm)

• Width (mm)

• Water depth (mm)

• Nearby Structures

  Select Weir Overflow Culvert Incoming Pipes Other None

  • Weir
  • Overflow
  • Culvert
  • Incoming Pipes
  • Other
  • None

• If other, please state

• Material

  Select Masonry Brick Concrete VC Cast iron Timber PVC Other

  • Masonry
  • Brick
  • Concrete
  • VC
  • Cast iron
  • Timber
  • PVC
  • Other

• Shape

  Circular

  Arch

  Box

  Egg

  Other

• Type

  Syphon

  Straight

• Assumed silt level?

  up to 25%

  up to 50%

  up to 75 %

  over 75%

• Photo of Inlet Area

  Media

• Why not found? (Overgrown, Denied Access, etc.)

• Vegetation clearance required?

  Yes

  No

• Access to Inlet

• Type of Access

  Select Field Hard Standing Towpath Road Possible Restrictions Weight Limit

  • Field
  • Hard Standing
  • Towpath
  • Road
  • Possible Restrictions
  • Weight Limit

• Please state possible restrictions (e.g. Key)

• Please state the weight limit

• Land Owner Details :

• Land Access Payment Required

  Yes

  No

• Value of Payment (£)

• Additional notes

• Overhead services

  Yes

  No

Culvert outlet

• Outlet found?

  Yes

  No

• Photo of Outlet structure

  Media

• Comments

• Photo of Watercourse downstream from outlet

  Media

• Comments

• Photograph of culvert internal

  Media

• Comments

• Height (mm)

• Width (mm)

• Water depth (mm)

• Nearby Structures

  Select Weir Overflow Culvert Incoming Pipes Other None

  • Weir
  • Overflow
  • Culvert
  • Incoming Pipes
  • Other
  • None

• If other, please state

• Material

  Select Masonry Brick Concrete VC Cast iron Timber PVC Other

  • Masonry
  • Brick
  • Concrete
  • VC
  • Cast iron
  • Timber
  • PVC
  • Other

• Shape

  Circular

  Arch

  Box

  Egg

  Other

• Type

  Syphon

  Straight

• Assumed silt level?

  up to 25%

  up to 50%

  up to 75 %

  over 75%

• Photo of Outlet Area

  Media

• Why not found? (Overgrown, Denied Access, etc.)

• Vegetation clearance required?

  Yes

  No

• Access to Outlet

• Type of Access

  Select Field Hard Standing Towpath Road Possible Restrictions Weight Limit

  • Field
  • Hard Standing
  • Towpath
  • Road
  • Possible Restrictions
  • Weight Limit

• Please state possible restrictions (e.g. Key)

• Please state the weight limit

• Land Owner Details :

• Land Access Payment Required

  Yes

  No

• Value of Payment (£)

• Additional notes

• Overhead services

  Yes

  No

Additional photos

• Additional photo 1

  Media

• Note

• Additional photo 2

  Media

• Note

• Additional photo 3

  Media

• Note

• Additional photo 4

  Media

• Note

• Additional photo 5

  Media

• Note

• Additional photo 6

  Media

• Notes

Identified Hazards, Environmental & pollution control

• Damming Required

  Yes

  No

• Type of Damming required

  Select Sand bags Fabric dams Trench sheet Piled dams Water filled dams Not required

  • Sand bags
  • Fabric dams
  • Trench sheet
  • Piled dams
  • Water filled dams
  • Not required

• Pollution controls

  Straw bale

  Sedimat

  Not required

• Potential Bat Roost

  Yes

  No

• Details of other environmental hazards identified

• Please describe the proposed method to complete the job

• Is Jetting Required?

  Yes

  No

• Type of Jetter

  Agrivac

  Towed Jetting Trailer

  Small Jetting Tanker

  Large Jetting Tanker

• Describe access for jetter (good, reasonable, poor etc.

• How much cable/suction hose is needed to reach the site?

  0 - 25m

  25 - 50m

  50 - 75m

  75 - 100m

  100m+

• Preferred Side of Survey

  Inlet

  Outlet

• Other comments ( minor works , observations etc