Information
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Client / Site
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Personnel
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Date and Time of Inspection
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Location
Location Details
General Information
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Drainage area
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Please specify
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Drain Ownership
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Pipe length
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Pipe size
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Distance to blockage from the manhole
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Is this a recurrence of an incident?
Nature of Incident
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Consequence of problem
- Blockage
- Flooding
- Pollution
- Odor
- Overflowing drain
- Blocked sink
- Others
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Please specify
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Flooding Extent
- Garden
- Internal
- Watercourse
- Highway
- Public / Open Space
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Content of blockage
- Grease
- Roots
- Sanitary products
- Wet wipes
- Brick, rock or rubble
- Hair
- Others
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Structual Causes
- Interceptor Trap
- Broken Pipe / Displaced Joint
- Broken Pipe Material Or Bricks At The Blockage Site
- Other
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Please specify
Work Undertaken
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Action Taken
- Rodded
- Jetted
- Aborted Visit
- Washed Down
- Drain Chemicals
- Plunger / Drain Wire
- Other
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Please specify
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Outcome Of Work
- Drain Unblocked
- Public Drain Unable To Clear
- Blockage In Neighbours Property
- Revisit
- Other
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Please specify
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Further Action Required
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Further Action Taken
- Revisit
- Cctv Inspection
- Check Drain Cleared After Chemicals
- Other
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Please specify
Completion
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Recommendations
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Personnel (Full Name and Signature)