Charlton Degg

• Project name:

• Project Number:

• Water Authority Reference:

• Conducted on:

  Date

• Auditor:

• Principal Contractor:

• Contractor:

• Location
  Address

• Ovality

  Yes

  No

  N/A

• Vacuum

  Yes

  No

  N/A

• Exfiltration

  Yes

  No

  N/A

Vacuum/Exfiltration Testing equipment

• Gauge calibration checked?

• Calibration date:

• Due for calibration:

• serial

• Photos

  Media

• TRAFFIC MANAGEMENT

  Functional

  Needs improvement

  N/A

• FENCING & HSE SIGNAGE

  GOOD

  ADEQUATE

  INADEQUATE

  N/A

• Result of Test

  Pass

  Fail

  NA

Ovality

• Is ovality ball in good condition and appropriate diameter for testing mains

  Yes

  No

  N/A

• Result of test

  Pass

  Fail

  NA

• Photos

  Media

• Is laser ovality required?

  Yes

  No

  N/A

• Result of test

  Pass

  Fail

  NA

Comments/ Progress/ Instructions

• Comments

• Photos

  Media

• Prepared by

  Sign