MOBS PE RISER SURVEY

• Audit Title

• Client / Site

• Conducted on

  Date

• Document No.

• Prepared by

• Location
  Address

• Personnel

Site Details

• Site / Address

PE Riser Isolation

• Do you wish to examine PIV work areas on this MOBS PE RISER SURVEY?

  Yes

  No

  N/A

• Has a PIV been installed outside the building to enable isolation of the building complex? (G5 ref 7.3.1)

  Yes

  No

  N/A

• Has the PIV got the correct valve cover? (G5 ref 7.3.3)

  Yes

  No

  N/A

• Can the PIV be permanently identified? (G5 ref 7.3.3)

  Yes

  No

  N/A

• Has the PIV got the correct valve cover? (G5 ref 7.3.3)

  Yes

  No

  N/A

• Is the PIV accessible to enable isolation? (G5 ref 7.3.3)

  Yes

  No

  N/A

Riser Condition

• Do you wish to examine riser work areas on this MOBS PE RISER SURVEY?

  Yes

  No

  N/A

• Is PE riser pipe / fittings shrouded and protected from sunlight? (G5 ref 6.1.8)

  Yes

  No

  N/A

• Is the PE riser / laterals protected from accidental damage, tampering & vandalism? (G5 ref 6.4.1.2)

  Yes

  No

  N/A

• Is the riser correctly supported?

  Yes

  No

  N/A

Building Works / Alterations

• Do you wish to examine building works / alterations work areas on this MOBS PE RISER SURVEY?

  Yes

  No

  N/A

• Have any building works / alterations taken place since PE riser was installed?

  Yes

  NO

  N/A

• Have building works / alterations compromised the safety of the PE riser system? (e.g.. Built over / Cladding / External Insulation / Rendering)

  Yes

  NO

  N/A

• Are house entry tee isolation (Internal Stoppers) accessible? (i.e. via scaffolding or other working at height equipment if applicable)

  Yes

  No

  N/A

ECV (Emergency Control Valves)

• Do you wish to examine ECV work areas on this MOBS PE RISER SURVEY?

  Yes

  No

  N/A

• Has an ECV been installed on the inlet to each individual meter installation? (G5 ref 7.7.1)

  Yes

  No

  N/A

• Is the ECV suitable for the network pressure? (G5 ref 7.7.3)

  Yes

  No

  N/A

• Is the ECV key or lever securely attached to the operating spindle? (G5 ref 7.7.4)

  Yes

  No

  N/A

General Comments

• Any further comments or recommendations arising from this inspection?

• Add any additional relevant photos

  Media

• Have all required corrective actions been added as Actions to this inspection?

  Yes

  No

  N/A

• Please add any corrective actions to the appropriate questions above before completing this report

Sign Off

• Name & Signature of Inspector

  Sign