Title Page
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Site Work Order Number
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Site Name
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Date and Time
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Location
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Chainage From
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Chainage To
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Lot Number
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CONFIRM LOCATION: Has the Location and direction been physically marked out on the ground?
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Photo of Location marked out
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MATERIALS: Has bedding material docket been inspected or approved by Supervisor? (Class 3, Class 2, Sand)
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Photo of Delivery Docket (Not Mandatory)
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EXCAVATION: Trench width is 0.5 to 1 times with Trench Height. Benching required for anything over 1.5m depth.
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Photo of trench
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BEDDING: Check bedding is compacted until refusal and is a minimum depth of 100mm
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Photo of depth check
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INSTALLING CULVERTS: Are culverts haunched (Allowing for collar) and on the correct level?
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INSTALLING CULVERTS: Are Flush Joint pipes or boxed culverts butted and mortared / Rubber Ring pipes joined with ring in clean condition?
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INSTALLING CULVERTS: What is the % grade of the culvert?
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BACKFILLING: Was the trench backfilled?
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Which compaction Method was used?
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Photo of Compacted Trench
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INLET AND OUTLET: Are they free flowing with no obstructions?
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Photo of Inlet / Outlet
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Authorised Signature confirming the above is true and correct
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Client / Superintendent / Witness / Other Signature agreeing the above is true and correct