Land Development Final Acceptance Audit - duplicate

• GW Reference No:

• Location

• Conducted on

  Date
• Location
  Address

• Personnel

Sewer

• Is Sewer to be audited?

  Off

  On
MH

• Structure name

• Cover level with surrounding FSL

  Yes

  NC

  N/A

• Cover is accessible

  Yes

  NC

  N/A

• Other

• Photos

  Media
MS/TMS

• Structure name

• Cover level with surrounding FSL (hasn't dropped onto the riser)

  Yes

  NC

  N/A

• Cover is accessible

  Yes

  NC

  N/A

• Shroud central and not damaged

  Yes

  NC

  N/A

• Other

• Photos

  Media
Trenches &/or subsidence

• Trenches filled & level

  Yes

  NC

  N/A

• Other

• Photos

  Media

Water

• Is water to be audited?

  Off

  On

• Fire Plugs

Fire plug

• Location

• Cover level with surrounding FSL & central

  Yes

  NC

  N/A

• Fire plug central

  Yes

  NC

  N/A

• Marker post installed

  Yes

  NC

  N/A

• Road reflector installed

  Yes

  NC

  N/A

• Triangle painted on road facing hydrant

  Yes

  NC

  N/A

• Other

• Photos

  Media

• Stop Valves

SV

• Location

• Cover level with surrounding FSL & centred

  Yes

  NC

  N/A

• Spindle central

  Yes

  NC

  N/A

• Shroud central & not damaged

  Yes

  NC

  N/A

• Marker post (if required)

  Yes

  NC

  N/A

• Photos

  Media

• Other

• Trenches &/or Subsidence

Trenches &/or subsidence

• Trenches filled & level

  Yes

  NC

  N/A

• Other

• Photos

  Media

• Washout Box

Washout box

• Location

• Box level with FSL

  Yes

  NC

  N/A

• Ferrule accessible

  Yes

  NC

  N/A

• Other

• Photos

  Media