Information
-
NC Number
-
Property Address
-
Works Conducted on
-
Scope of Work performed?
-
Prepared by
-
Location
-
PID
-
Title Reference number
Fire & Domestic Connection/Disconnection Completion Sheet
Safety
-
Traffic Management /control needed?
-
Any Hazards on site have been added to SWMS spreadsheet & SWMS completed?
-
Photos of property prior to works being performed
Water Connection
-
Was a new water connection installed?
New Water Connection details
-
What size is the New Water Connection?
- ID20mm
- ID25mm
- ID32mm
- ID40mm
- ID50mm
- ID65mm
- ID80mm
- ID100mm
- ID150mm
- ID200mm
-
Photo showing the TPFNR installation
-
Photos showing pipework installation
-
Photos showing backfill
-
Photos showing the installation of metallic detector tape
-
Photos showing reinstatement of excavation area
-
What size is the new Fire Service Connection size?
- ID20mm
- ID25mm
- ID32mm
- ID40mm
- ID50mm
- ID65mm
- ID80mm
- ID100mm
- ID150mm
- ID200mm
-
What size is the Bypass Meter size?
-
How was the Fire service installed?
-
Clear photo showing the Bypass meter serial number & meter reading
-
Clear photo showing the Bypass meter radio number
-
Date the Fire service was installed
-
Meter serviced (e.g. unit 1) - Fire Service
-
Description of land at time of Connection - Fire Service
-
Date works were completed - Fire service
-
What size is the Domestic meter?
- ID20mm
- ID25mm
- ID32mm
- ID40mm
- ID50mm
- ID65mm
- ID80mm
- ID100mm
- ID150mm
- ID200mm
-
Domestic Meter size
- DN20mm
- DN25mm
- DN32mm
- DN40mm
- DN50mm
- DN65mm
- DN80mm
- DN100mm
- DN150mm
- DN200mm
-
How was the Domestic Meter installed?
- Above ground assembly
- Below ground in boundary boxes
- Below ground in trafficable boxes
- Cabinet arrangement
-
Clear photo showing the Domestic meter serial number & meter reading
-
Clear photo showing the Domestic meter radio number
-
Date of Domestic meter install
-
Meter serviced (e.g. unit 1) - Domestic
-
Description of land at time of Connection - Domestic
-
Is meter installation Complete?
Location details of Water connection Fire Service & Domestic Meter assembly
-
The measurements from the property boundaries
-
measurements from the nearest public road
-
The length (in metres) of the connecting pipework from the connection point to the water meter.
-
The depth (in millimetres) of the pipe work at the connection point and termination Water Meter for water
-
Northerly bearing
-
Was a new fire service and domestic assembly installed on existing water connection?
-
Details of Fire service and Domestic service
Details of Fire and Domestic assembly
-
Photo showing the installation of the Meter assembly
-
Photos showing pipework installation
-
Photos showing backfill
-
Photos showing reinstatement of excavation area
-
What size is the Fire Service connection?
- ID20mm
- ID25mm
- ID32mm
- ID40mm
- ID50mm
- ID65mm
- ID80mm
- ID100mm
- ID150mm
- ID200mm
-
What size is the Bypass Meter?
-
How was the Fire service installed?
-
Clear photo showing the Bypass meter serial number & meter reading
-
Clear photo showing the Bypass meter radio number
-
Date of Fire service install
-
Meter serviced (e.g. unit 1) - Fire Service
-
Description of land at time of Connection - Fire Service
-
Date works were completed - Fire service
-
What size is the Domestics water connection?
- DN20mm
- DN25mm
- DN32mm
- DN40mm
- DN50mm
- DN65mm
- DN80mm
- DN100mm
- DN150mm
- DN200mm
-
What size is the Domestic Meter?
- DN20mm
- DN25mm
- DN32mm
- DN40mm
- DN50mm
- DN65mm
- DN80mm
- DN100mm
- DN150mm
- DN200mm
-
How was the Domestic Meter installed?
- Above ground assembly
- Below ground in boundary boxes
- Below ground in trafficable boxes
- Cabinet arrangement
-
Clear photo showing the Domestic meter serial number & meter reading
-
Clear photo showing the Domestic meter radio number
-
Date of Domestic meter install
-
Meter serviced (e.g. unit 1) - Domestic
-
Description of land at time of Connection - Domestic
Location details of Water connection Fire Service & Domestic Meter assembly
-
The measurements from the property boundaries
-
measurements from the nearest public road
-
The length (in metres) of the connecting pipework from the connection point to the water meter.
-
The depth (in millimetres) of the pipe work at the connection point and termination Water Meter for water
-
Northerly bearing
Water Disconnection
-
Was an existing water connection capped & sealed?
-
What size is the existing water connection that was disconnected?
- ID20mm
- ID25mm
- ID32mm
- ID40mm
- ID50mm
- ID65mm
- ID80mm
- ID100mm
- ID150mm
- ID200mm
-
What size was the existing Meter that was removed?
- DN20mm
- DN25mm
- DN32mm
- DN40mm
- DN50mm
- DN65mm
- DN80mm
- DN100mm
- DN150mm
- DN200mm
-
Date of meter removal
-
Meter serviced (e.g. unit 1)
-
Photo showing the existing connection
-
Clear photo showing the meter serial number & meter reading
-
Clear photo showing the meter radio number
-
Photo showing the cap and seal of existing connection
-
Photos showing backfill
-
Photos showing reinstatement of excavation area
-
Description of property at time of works being performed?
Location details of disconnected water connection
-
The measurements from the property boundaries to disconnection point on TasWater main.
-
The measurements from the nearest public road to disconnection point on TasWater main.
-
Northerly bearing
Panel Member Sign off of Works Completed
-
Full name of onsite supervisor
-
Full name of onsite plumber
-
Comments
