Information
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Document No.
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SAM Number:
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DA #:
- 00
- 01
- 02
- 03
- 04
- 05
- 06
- 07
- 08
- 09
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
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Drawing Revision #:
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Conducted on
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Prepared by
Checklist Revision History
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Design Validation Review Rev 1.0 02/02/2016.
Design Validation
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Asset
Asset:
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Asset ID or Drawing reference:
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Asset type:
- Pit
- Duct
- Node
- Pillar
- Joint
- Multiple elements
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Select Pit size:
- P2
- P3
- P4
- P5
- P6
- P8
- P9
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
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Enter Location here:
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Select Event Type:
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Select Reason:
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Select additional requirement
- Traffic Management required
- ACM affected
- Dewatering required
- Power
- Missing rope
- Blockage
- Trees / shrubs obstruction
- Construction risk
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Enter change details
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Attach Photograph(s):
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Select duct size:
- P20
- P50
- P80
- P100
- A50
- A80
- A100
- If Other enter below
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If other enter details here:
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Enter Location here:
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Select Event Type:
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Select Reason:
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Select additional requirement
- Traffic Management required
- ACM affected
- Dewatering required
- Power
- Missing rope
- Blockage
- Trees / shrubs obstruction
- Construction risk
-
Enter change details
-
Attach Photograph(s):
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Enter Location here:
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Select Event Type:
-
Select Reason:
-
Select additional requirement
- Traffic Management required
- ACM affected
- Dewatering required
- Power
- Missing rope
- Blockage
- Trees / shrubs obstruction
- Construction risk
-
Enter change details
-
Attach Photograph(s):
-
Enter Location here:
-
Select Event Type:
-
Select Reason:
-
Select additional requirement
- Traffic Management required
- ACM affected
- Dewatering required
- Power
- Missing rope
- Blockage
- Trees / shrubs obstruction
- Construction risk
-
Enter change details
-
Attach Photograph(s):
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Select Joint type:
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Enter Location here:
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Select Event Type:
-
Select Reason:
-
Select additional requirement
- Traffic Management required
- ACM affected
- Dewatering required
- Power
- Missing rope
- Blockage
- Trees / shrubs obstruction
- Construction risk
-
Enter change details
-
Attach Photograph(s):
-
Enter Location here:
-
Select Event Type:
-
Select Reason:
-
Select additional requirement
- Traffic Management required
- ACM affected
- Dewatering required
- Power
- Missing rope
- Blockage
- Trees / shrubs obstruction
- Construction risk
-
Enter change details
-
Attach Photograph(s):
