IMR WR enabling form - V1

Jim Eldred

IMR WR enabling form - V1

Enabling form to capture specific info and allow planning and undertaking of waste water repair and maintenance works

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Enabling info

SAP work order
Please select main work type - TUP
- gravity sewer
- rising main
- manhole cover & frame
- manhole repair
- interceptor
- no dig - lining etc.
- Non return valves
- non-standard works
Conducted on
- Jason Simpson
- Niel Roach
- Scott Taylor
- Tim Cornwell
- Jim Eldred
Tap location to geo reference where enabling being carried out
Add media
Please enter address location if not as IMR form indicates or do not have GPS connection
Add detail

Site specifics

Geo tag location of works to be carried out (may differ from IMR form)
Please take photos of site applicable to works location and comment.
Comments
Please select TM requirements
- Chapter 8
- Stop & Go
- 2 way lights
- 3 way lights
- 4 way lights
- Road closure
- Footpath closure
Please add any additional TM requirements here.
Add media
Please select road speed and applicable road type.
- <30mph
- 40mph
- 50mph
- 60mph
- 70mph
- Single carriageway
- Dual carriageway
- Motorway
Comments.
Add media
Please enter ground conditions at observed ground level.
- Gravel
- Concrete
- Tarmac
- Block paving
- Unmade ground
- Sand/silts
Please add any additional info.
Comments
Add media
Depth to pipe
Assumed depth of excavation
Meterage of repair
Flow %
Pipe size
- 75mm
- 100mm
- 125mm
- 150mm
- 200mm
- 225mm
- 300mm
- 350mm
- 375mm
- 400mm
- 450mm
- 475mm
- 500mm
- 525mm
- 600mm
- 650mm
- 675mm
- 700mm
- 750mm
- 850mm
- 900mm
- 1000mm
- other
Pipe material
- VC
- pitch fibre
- concrete
- UPVC
- MDPE
- Cast iron
- Ductile iron
- Asbestos
Please enter MH cover size
If non standard size please add info.
Comments
Photos of cover (with tape measure also)
Sewer type
- foul
- SW
- combined
- pressurised main
Sewer system
- public
- ex sect 24
- transferred

Job requiements

Site Hazards identified
- overhead cables
- gas mains MP/HP
- HV electric cables
- Data/fibre optics
- Rail - level crossings etc.
- Schools
- hospitals/fire stations
- other (specify in comments)
Please comment where applicable
Comments
Add media
Environmental and other hazards.
- SSSI
- archeological
- water course
- land owners
- TPO's (heavy foliage)
- buildings and easements
- other (please add comments)
Please comment where applicable
Add media
Additional site photos
Photo information
Add signature

IMR WR enabling form - V1

Jim Eldred

IMR WR enabling form - V1

Enabling form to capture specific info and allow planning and undertaking of waste water repair and maintenance works

Use this Template

Print as PDF

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.

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IMR WR enabling form - V2

IMR WR enabling form - V2