Title Page
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Conducted on
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Reference
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Address
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CRM Task
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Work performed after hours?
SAFETY
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Tool Box Meeting Recorded
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Risk Assessment Number
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Risk Assessment Completed
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Service
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Comments
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Information Required
- Sewer Overflow -DRY weather
- Sewer Overflow-WET weather
- Blocked sewer -No Overflow
- Sewer Odour
- Routine Main Inspection
- Jet Clean Sewer
- Camera Sewer Line
- Manhole Repair
- Sewer Repair
- Eel Sewer
SEWER
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Type
- House Line
- Boundary Trap
- Council Side Line
- Manhole
- Main Sewer
- Trunk Sewer
- Rising Main
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Cause
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Further Action
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Further Action Status
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Estimated number of properties affected
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Information Required
- Pathcock Repair
- Meter Repair
- Service - Mains to Meter
- No Water
- Pressure Problem
- Dirty Water/ Taste
- Water Mains
- Valve/ Hydrant Maintenance
- Chlorine Failure
- Chlorine Test
WATER MAIN BREAK
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Size
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Other Size please specify
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Type
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Problem
- Cracking (Circular)
- Cracking (Longitudinal)
- Internal Corrosion
- External Corrosion
- Pressure Break
- Split Pipe
- Damage by others
- Other
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Other please specify
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Repair Method
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Time Shut Off
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Time Restored
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Estimated number of properties affected
CLOSING INFORMATION
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Time Job Completed
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Date Job Completed
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Number of Staff
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Customer notified
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Contact Centre Notified
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Charge to property
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NO further Action
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Comments
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Actions recommended
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Officer
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Mobile