Page 1: Initial questions

  • Conducted on

  • Prepared by

  • Location
  • PN

  • Chamber Size

  • Sub-Contractor Gang

Page 2: Main checklist

  • Have sufficient rings been fitted to allow correct depth of cover

  • Has 100mm of compacted Type 1 been installed in base of excavation

  • has a sump been installed in FW4, FW6, CW1 & CW2

  • Has 50mm of dry mix concrete or C40 concrete been installed for chamber floor - FW Chamber Only

  • Are ducts cut flush with chamber wall

  • Are duct entries a minimum 75mm from the corner

  • Are Duct entries a minimum 150mm from base

  • Have brackets and bearers been fitted

  • Have surround to FW chamber been backfilled with compacted Type 1 or lean mix concrete (C40)

  • Has the FW frame & cover been bedded on 15mm - 40mm rapid set mortar

  • Has a concrete (C25/C30) surround been installed around the frame & cover to a width of 100mm - Verge Only

  • Is the frame & cover flush with the existing surface

  • Is reinstatement in accordance with SROH

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.