Title Page
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Conducted on
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Prepared by
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Location
Pre-testing Checklist
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Has a testing request been lodged with the Authority?
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Accepted Authority Ref:
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Has the contractor carried out a pre-test?
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Date of pre-test:
Live Works
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Are any live works being carried out with testing? Eg. Insertion / removal of plugs?
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Accepted Authority Ref (Eg Form Q14505)
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Do you have a copy of the accepted form on site with you?
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Have you confirmed with the contractor what works will be carried out today, as per the accepted form?
Equipment Check
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Gauge Serial No. and Calibration date (Certificate Checked: )<br>Note: calibration date to be within 12 months of today’s date)
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Gauge 1 S/N
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Gauge 1 Cal. Date:
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Gauge 2 S/N
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Gauge 2 Cal. Date:
MH Testing Notes
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Number of MHs to be tested: Note: Cast in situ 1 in 5 | Pre-cast All
MH Test Results
- Manhole Test 1
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MH Number
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Test Vacuum Pressure -35 kPa -28 kPa (kPa)
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Test Duration 3m 3m (minutes)
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Pressure Loss < 5kPa allowable (kPa)
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Test Result
Manhole Test 2
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MH Number
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Test Vacuum Pressure -35 kPa -28 kPa (kPa)
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Test Duration 3m 3m (minutes)
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Pressure Loss < 5kPa allowable (kPa)
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Test Result
Manhole Test 3
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MH Number
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Test Vacuum Pressure -35 kPa -28 kPa (kPa)
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Test Duration 3m 3m (minutes)
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Pressure Loss < 5kPa allowable (kPa)
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Test Result
Manhole Test 4
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MH Number
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Test Vacuum Pressure -35 kPa -28 kPa (kPa)
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Test Duration 3m 3m (minutes)
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Pressure Loss < 5kPa allowable (kPa)
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Test Result
Manhole Test 5
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MH Number
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Test Vacuum Pressure -35 kPa -28 kPa (kPa)
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Test Duration 3m 3m (minutes)
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Pressure Loss < 5kPa allowable (kPa)
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Test Result
Manhole Test 6
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MH Number
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Test Vacuum Pressure -35 kPa -28 kPa (kPa)
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Test Duration 3m 3m (minutes)
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Pressure Loss < 5kPa allowable (kPa)
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Test Result
Manhole Test 7
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MH Number
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Test Vacuum Pressure -35 kPa -28 kPa (kPa)
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Test Duration 3m 3m (minutes)
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Pressure Loss < 5kPa allowable (kPa)
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Test Result
Manhole Test 8
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MH Number
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Test Vacuum Pressure -35 kPa -28 kPa (kPa)
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Test Duration 3m 3m (minutes)
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Pressure Loss < 5kPa allowable (kPa)
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Test Result
Manhole Test 9
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MH Number
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Test Vacuum Pressure -35 kPa -28 kPa (kPa)
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Test Duration 3m 3m (minutes)
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Pressure Loss < 5kPa allowable (kPa)
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Test Result
Manhole Test 10
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MH Number
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Test Vacuum Pressure -35 kPa -28 kPa (kPa)
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Test Duration 3m 3m (minutes)
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Pressure Loss < 5kPa allowable (kPa)
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Test Result
Sewer Pipe Segment Tests
Sewer Pipe Segment Tests 1
Segment Details
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From
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To
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Length
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Diamater
Ovality Testing
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Ovality Ball Diameter Checked
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Ovality Ball Test
Pressure / Vacuum Testing
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Test Type
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Test Duration
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Test Pressure
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Pressure Loss
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Test Result
Sewer Pipe Segment Tests 2
Segment Details
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From
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To
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Length
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Diamater
Ovality Testing
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Ovality Ball Diameter Checked
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Ovality Ball Test
Pressure / Vacuum Testing
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Test Type
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Test Duration
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Test Pressure
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Pressure Loss
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Test Result
Sewer Pipe Segment Tests 3
Segment Details
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From
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To
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Length
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Diamater
Ovality Testing
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Ovality Ball Diameter Checked
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Ovality Ball Test
Pressure / Vacuum Testing
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Test Type
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Test Duration
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Test Pressure
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Pressure Loss
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Test Result
Sewer Pipe Segment Tests 4
Segment Details
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From
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To
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Length
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Diamater
Ovality Testing
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Ovality Ball Diameter Checked
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Ovality Ball Test
Pressure / Vacuum Testing
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Test Type
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Test Duration
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Test Pressure
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Pressure Loss
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Test Result
Sewer Pipe Segment Tests 5
Segment Details
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From
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To
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Length
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Diamater
Ovality Testing
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Ovality Ball Diameter Checked
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Ovality Ball Test
Pressure / Vacuum Testing
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Test Type
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Test Duration
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Test Pressure
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Pressure Loss
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Test Result
Sewer Pipe Segment Tests 6
Segment Details
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From
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To
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Length
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Diamater
Ovality Testing
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Ovality Ball Diameter Checked
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Ovality Ball Test
Pressure / Vacuum Testing
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Test Type
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Test Duration
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Test Pressure
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Pressure Loss
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Test Result
Sewer Pipe Segment Tests 7
Segment Details
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From
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To
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Length
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Diamater
Ovality Testing
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Ovality Ball Diameter Checked
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Ovality Ball Test
Pressure / Vacuum Testing
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Test Type
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Test Duration
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Test Pressure
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Pressure Loss
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Test Result
Sewer Pipe Segment Tests 8
Segment Details
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From
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To
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Length
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Diamater
Ovality Testing
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Ovality Ball Diameter Checked
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Ovality Ball Test
Pressure / Vacuum Testing
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Test Type
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Test Duration
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Test Pressure
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Pressure Loss
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Test Result
Sewer Pipe Segment Tests 9
Segment Details
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From
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To
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Length
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Diamater
Ovality Testing
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Ovality Ball Diameter Checked
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Ovality Ball Test
Pressure / Vacuum Testing
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Test Type
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Test Duration
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Test Pressure
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Pressure Loss
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Test Result
Sewer Pipe Segment Tests 10
Segment Details
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From
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To
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Length
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Diamater
Ovality Testing
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Ovality Ball Diameter Checked
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Ovality Ball Test
Pressure / Vacuum Testing
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Test Type
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Test Duration
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Test Pressure
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Pressure Loss
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Test Result
