Charlton Degg

• Project name:

• Project Number:

• Water Authority Reference:

• Conducted on:

  Date

• Auditor:

• Principal Contractor:

• Contractor:

• Location
  Address

• Swabbing

  Yes

  No

  N/A

• Pressure testing

  Yes

  No

  N/A

• Chlorination/Water Quality

  Yes

  No

  N/A

• TRAFFIC MANAGEMENT

  Functional

  Needs improvement

  N/A

• FENCING & HSE SIGNAGE

  GOOD

  ADEQUATE

  INADEQUATE

  N/A

Pressure Testing equipment

• Gauge calibration checked?

• Calibration date:

• Due for calibration:

• serial

• Test Pressure

• Test Duration

  15 Mins - No loss

  5 Hours - MRWA 19.4.1.1

• Result of Test

  Pass

  Fail

  NA

Swabbing

• Oversized Swabs

  Yes

  No

  N/A

• Insertion location labelled?

  Yes

  No

  N/A

• Result of test

  Pass

  Fail

  NA

• Measures in place to prevent Scouring/Flooding

  Yes

  No

  N/A

Comments/ Progress/ Instructions

• Comments

• Photos

  Media

• Prepared by

  Sign