Title Page
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GW Reference No:
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Location
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Conducted on
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Location
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Personnel
Sewer
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Is Sewer to be audited?
MH
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Structure name
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Cover level with surrounding FSL
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Cover is accessible
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Other
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Photos
MS/TMS
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Structure name
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Cover level with surrounding FSL (hasn't dropped onto the riser)
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Cover is accessible
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Shroud central and not damaged
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Other
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Photos
Trenches &/or subsidence
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Trenches filled & level
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Other
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Photos
Water
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Is water to be audited?
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Fire Plugs
Fire plug
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Location
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Cover level with surrounding FSL & central
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Fire plug central
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Marker post installed
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Road reflector installed
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Other
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Photos
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Stop Valves
SV
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Location
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Cover level with surrounding FSL & centred
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Spindle central
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Shroud central & not damaged
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Marker post (if required)
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Photos
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Other
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Trenches &/or Subsidence
Trenches &/or subsidence
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Trenches filled & level
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Other
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Photos
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Washout Box
Washout box
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Location
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Box level with FSL
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Ferrule accessible
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Other
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Photos