Site specifics

Site Specific Information.
Please select TM requirements
Please select road speed and applicable road type.

Please add any additional TM requirements here.

Photos of where TM will be required (please get clear shots of road, access etc.)
Please enter ground conditions at observed ground level.

Please add any additional info on work area and ground conditions.

Photos of work area.
Depth to invert of pipe (when known)
Assumed depth of excavation required (when known)
Meterage of repair required (when known)
Flow %
Pipe size
Pipe material

Please enter MH cover size - If not an option measure the opening sizes and depth of iron work and add below in comments.

If non standard size please add info.Comments

Photos of cover (with tape measure also)
Sewer type
Sewer system
Site Hazards identified

Please add any relevant information and photos below.

Add media
Environmental and other hazards.

Please add any applicable information and photos if required.

Add media

Job requiements

Job Requirements

Please enter job requirements below i.e. plant, materials, durations etc.

Please add photos of site, mark ups, etc. (annotate pictures where applicable)
Please Sign once competed.
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.