HSQE 38 - Drainage Sign Off Sheet

Drainage Sign Off Sheet

• Contract

  Select

• Carried Out By

• Drainage Run

• Date

  Date

• Location

Manhole Ref:

• Type of Manhole

• Cover Level:

• Invert Level:

• Benching Accepted

  Yes

  No

  N/A

• Pointing Accepted

  Yes

  No

  N/A

• Cover Slab and Manhole Cover Accepted

  Yes

  No

  N/A

Pipeline

• Pipe Diameter

• Pipe Material

• Surround Material

• Backfill

  Yes

  No

  N/A

• Spurs

  Yes

  No

  N/A

• All Spurs Accepted

  Yes

  No

  N/A

• Air Tested By

• Pipeline/s Accepted

  Yes

  No

  N/A

Signatures

• Signed on Behalf of Client

  Sign

• Signed on Behalf of MTG

  Sign

Snagging

• Snagging Required for Above

  Yes

  Not Required

• All Snagging Rectified and all items Acceptable

  Yes

  No

  N/A

• Signed on Behalf of Client

  Sign

• Signed on Behalf of MTG

  Sign