Proceeding Works Form - Ver 1

• Press the pin to get an accurate Location
  Address

• PERMIT NUMBER:

CP1.10 Checksheet

• Lead Man

  Select

• Address of Excavation on Permit

• Crew Manager

  Select

• Date of Works

  Date

• Client

  Avonline

  Kier

  KN Circet

• Nature of works

  Select

Site setup

• Has an SSRA been completed before work commences?

  Yes

  No

  N/A

• Has the chapter 8 been set out as per the red book for this type of excavation?

  Yes

  No

  N/A

• Is there any risk to the general public? If 'Yes' then please note potential hazards. Please contact your manager to see if works can still commence.

  Safe

  At Risk

  N/A

• Are you wearing the correct PPE for the nature of work. Please get you partner to take a full photo of you in your PPE x 2 (Each Member)

  Media

• Please take a photo of the property to include the mark up location.

  Media

• Please take a photo of the condition of the footway/ Carriageway surrounding the excavation taking place, too include any historic defects.

  Media

• Please take a photo of your work space closed off from the general public.

  Media

Site

• Surface profile?

  Select 6mm 10mm Mastic HRA Verge Concrete Slabs/ Mods N/A

  • 6mm
  • 10mm
  • Mastic
  • HRA
  • Verge
  • Concrete
  • Slabs/ Mods
  • N/A

• Has your CAT been used to prove other utilities to avoid strikes. Please provide proof.

  Media

• Please provide evidence of your working GDU on site

  Media

SITE Excavation Evidence

• Please take several photos of the area to be excavated.

  Media

SITE 1 Proof Photo

• Please take a photo of surface removal.

  Media

SITE 2 Proof Photo

• Please take a photo of excavated area relevant to the nature of works.

  Media

SITE 3 Proof Photo

• Please take a photo of the nature of your excavation. E.G. Damaged duct, Installed swept Tee ETC.

  Media

SITE 4 Proof Photo

• Please take a photo of the work completed. E.G. Repaired duct, installed swept tee ETC.

  Media

REINSTATEMENT PHOTOS

• Please take evidence of the type 1 subbase compacted and at the correct depth with surface edging prept.

  Media

• Please take evidence of stage 1 of surface compacted satisfactorily.

  Media

• Please take evidence of second stage surface compacted. Please ensure this has been compacted with the relevant passes required to satisfy the LA to avoid any defects.

  Media

• Has the work completed to a good standard?

  Yes

  No

  N/A

DIMS DIMENSIONS

• Length?

• Width?

• Depth?

Signature

• Lead Man Signature.

  Sign