P4 Template - All Projects

• Project

  CFL

  LIT

  Connect

• Job Number

• Have you sent the Permit Manager your Stop Time? (This includes- Job Number, Road Name and Stop Time)

  Yes

  No

  N/A

• The information above MUST be sent to- 07394915254. This is for ALL civils jobs (private and Permit). Failure to do so within 2 hours of stopping a job can result in large fines.

• Location
  Address

• Conducted on

  Date

• Conducted By

Site Images

• Images are to be taken at all stages of an excavation. Please ensure we have permit boards, barriers, cones, signage and surface scanned spray markings. Once images of the site set up have been submitted, a manager will sign off to allow works to commence. Works should not commence prior to this.

• Images of the work area BEFORE the site is set up

  Media

• Images of the site set up BEFORE any works commence (This MUST be wide angle. The house number should be included, if possible)

  Media

• Images of Cat and Genny Markings

  Media

• Images of the permit board (Writing must be clear)

  Media

• Manager sign off (Works may only start once a PICH Group Ltd manager has signed off on the requested images above)

  Sign

Excavation

• Excavation Address (Road name and house number)

• Excavation location
  Address

• What three words

• Length

• Width

• Depth

• Surface type

  Select Slab Concrete Hot lay Mastic Tarmac Asphalt Grass

  • Slab
  • Concrete
  • Hot lay
  • Mastic
  • Tarmac
  • Asphalt
  • Grass

• Open Excavation Images

  Media

• Proof of blockage repair (including cable ties etc)

  Media

• Images of Back Fill (Type 1/sand)

  Media

• Closed Excavation Images

  Media

• Site Clear Images (No equipment left onsite)

  Media

• Temp or Perm reinstatement

  Temp

  Perm

• Reason for Temp

• Choose the relevant task and provide the images that are requested.

• Type of task complete

  Blockage

  Chamber Build

  Pole Bend

  Temp to Perm

• Has the Duct been Roped or Cabled

  Roped

  Cabled

  N/A

• Give reasons for not being roped or cabled.

• Image of Chamber A showing rope or cable

  Media

• Image of Chamber B showing rope or cable

  Media

• Were 3 Modules achieved

  Yes

  No

  N/A

• images of reason why (Other Utilities etc)

  Media

• Images of duct installed and core drill within both chambers

  Media

• Images of newly built chamber

  Media

• Image of newly installed duct in BT Chamber with rope

  Media

• Image of duct at pole with rope

  Media

• Tarmac Tubs 6mm

• Tarmac Tubs 10mm

• Sand (Buckets)

• Type 1 (Buckets)

• Ducting (Meter)

• Duct Repair 2a

• Duct Repair 3a

• Split Duct (Meter)

• Comments

• Works Sign Off

  Sign