Location Details

General Information

Drainage area

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Drain Ownership

Pipe length

Pipe size

Distance to blockage from the manhole

Is this a recurrence of an incident?

Nature of Incident
Consequence of problem

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Flooding Extent
Content of blockage
Structual Causes

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Work Undertaken
Action Taken

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Outcome Of Work

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Further Action Required

Further Action Taken

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Personnel (Full Name and Signature)