Dee Valley Water - Hygiene & Quality Performance Monitoring Record

• WW50 / Job number

• Site name

• Location
  Address

• Conducted on

  Date

• Personnel that were observed / communicated with

• Add signature

  Sign

CONNECTING ONTO LIVE PIPEWORK SERVICES & MAINS

• Hygiene kit on site

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Sump excavated to 300mm below the invert of the pipe

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Suitable de-watering pump used

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Water kept below invert of pipe

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Fittings / pipe stored correctly

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Repair pipe, fittings & all hand tools disinfected

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• All sources of contamination e.g. Fuels/oils stored away from excavation

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Have relevant standard operating procedures been followed

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

QUALITY CHECK FOR LAYING MAINS / SERVICES

• Depth of trench

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Bedding / fine fill around pipe

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Pipe laying method - clamps etc.

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Flanges / bolts

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Wrapping

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Thrust blocks

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Service connections

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Depth of services

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Depth of fittings, W/O chambers etc.

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Compaction of backfill

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Clegg readings

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Reinstatement specifications

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Have the relevant standard operating procedures been followed

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

GENERAL ACTIVITY

• Risk assessments & plans

  Safe

  At Risk

  N/A

• Quality documentation

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Hygiene cards / forms & identity cards

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Vehicle & equipment safety / security

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Vehicle tidiness (cab / rear free of hazards)

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Advance signing of works

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Apology boards

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Site signing

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Location of utilities

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Safe excavation

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Guarding of excavation

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Traffic control

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Pedestrian access

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Disposal of spoil

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Mains/service work

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Connection hygiene

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Pipe surround & backfill

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Reinstatement: Tarmac / paving / concrete

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Vibration: Check rotation, tools used, assess time

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Check hearing defenders being worn when using vibrating/noisy (>80dB) tools

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• PPE: check ear / eye protection

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• PPE: Head protection

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• PPE: Hi-viz vest/coat & trousers

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• PPE: Footwear

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• First aid facilities & eye-wash

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Hand wash facilities (hand cleaner, sanitizer & barrier cream)

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Storage of materials (safe disposal)

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Cleanliness / professionalism of site

  Major corrective actions required

  Minor corrective actions required

  Acceptable

  Fully acceptable

  Not observed

• Signed by inspector

  Sign

• Signed by manager - actions have been logged / will be addressed

  Sign