Title Page

  • Conducted on

  • Prepared by

  • Location

Hydrants

  • All Surrounds and covers in place (Surrounds undamaged, word "water" visible)

  • All cover levels flush with FSL (If no FSL, 2m topsoil surround required)

  • Chains attached to all lids

  • All heads 100-200mm below cover

  • All interiors cement stabilised

  • All hydrant marker posts in place as required (concrete footing required)

  • All blue RRPMs/Road Patches in place as required

  • Water ponding in hydrants eliminated

  • Hydrant supported to prevent rocking

. Valves

  • All surrounds and covers in place (words "water" and "valve" or ”SV” visible, marker discs as required)

  • All cover levels flush with FSL

  • All spindles 100-350mm below cover

  • Cover supported to prevent rocking

  • Kerb discs/Posts in place as required

Trenches

  • No subsidence evident in pavement and/or soil

  • Grass established

. Pavements

  • All pavements reinstated as required

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.