INTERFLOW - Civil Works Identification Audit - Sewer

• Conducted on

  Date

• Prepared by

• Location
  Address

• Select date

  Date

• Works Package

• Line Number

• Pipe Diameter

• Flow Rate

  Select Slow Average High

  • Slow
  • Average
  • High

• U/S Manhole Number

• Gas Levels

  Select High Normal Very High Not Applicable

  • High
  • Normal
  • Very High
  • Not Applicable

• D/S Manhole Number

• Gas Levels

  Select High Normal Very High Not Applicable

  • High
  • Normal
  • Very High
  • Not Applicable

• Reason for Civil Works

  Select Buried Manhole Damaged/Undersized Manhole Displaced Junction Dropper End of Line IS Failed Interfit Intermediate IS Mains Spot Repair Pit rebuild/demolition Un-interfitable connection Other

  • Buried Manhole
  • Damaged/Undersized Manhole
  • Displaced Junction
  • Dropper
  • End of Line IS
  • Failed Interfit
  • Intermediate IS
  • Mains Spot Repair
  • Pit rebuild/demolition
  • Un-interfitable connection
  • Other

• Details of Dig - please add notes and photos of site.

• Site Images

  Media

• Has the dig site been clearly and accurately marked?

  Select Yes No Not Applicable

  • Yes
  • No
  • Not Applicable

• How was the dig marked?

  Select Camera Reel Sonde Trundle Wheel Other

  • Camera Reel
  • Sonde
  • Trundle Wheel
  • Other

• Who marked the dig?

• Site images

  Media
• Excavation Address
  Address

• Property Resident Contact Details

• Excavation Location

  Select Roadway Footpath Laneway Naturestrip Driveway Front Yard Back Yard Park / Reserve Other

  • Roadway
  • Footpath
  • Laneway
  • Naturestrip
  • Driveway
  • Front Yard
  • Back Yard
  • Park / Reserve
  • Other

• Surface Material

  Select Asphalt Bluestone Concrete Lawn/Garden Paving/Tiles Other

  • Asphalt
  • Bluestone
  • Concrete
  • Lawn/Garden
  • Paving/Tiles
  • Other

• Is reinstatement of concrete or asphalt required?

  Select Yes No Not Applicable

  • Yes
  • No
  • Not Applicable

• Excavator Access

  Yes - Good Access

  Yes - Access Issues to be addressed

  No

• Known Obstructions

  Select None Buildings Traffic Walls Trees Power/Phone Poles Other

  • None
  • Buildings
  • Traffic
  • Walls
  • Trees
  • Power/Phone Poles
  • Other

• Is Traffic Management required?

  Select Yes No Not Applicable

  • Yes
  • No
  • Not Applicable

• Dig Depth

• Dig Length

• U/S Manhole Depth

• D/S Manhole Depth

• Has the resident been notified of intended works?

  Select Yes No Not Applicable

  • Yes
  • No
  • Not Applicable

• Has a Home Plan been completed with the Resident?

  Select Yes No Not Applicable

  • Yes
  • No
  • Not Applicable

• General Comments

Sample Summary and Signoff

• Name and signature of inspector

  Sign