Information
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Site conducted
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Prepared by
- Mick Greenfield
- Darron tonks
- Nigel Tonks
- Dave Morgan
- Steve Holland
- Katrina Roberts
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Job Number
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Site Address
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Works Description
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Date of Visit
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Team Leader / Mates
- Gary Bram
- Antony Facer
- Ryan Facer
- Chris Garratt
- Adam Greenfield
- Peter Rowley
- David Green
- Chris Tonks
- Zak Tonks
- Phil Tonks
- Dave Hardwick
- Steve White
- Ben Strickland
- Dave Wright
- Kyle Wright
- Nigel Tonks
Qualifications .1
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Gas Qualification Team Leader (level 1, Level 2 etc.)
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Gas Qualification Team Mate (level 1, Level 2 etc.)
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Gas Network Safety Passport (All Team Members)
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Gas Safe Registration Card
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NRSWA Operators Card Onsite
Documentation .2
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Site Specific Risk Assessment in Use, Signed and Dated
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Contract Job Pack on Site
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Existing Utilities Plans on Site and in Use
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Are the As-Laid Drawings Being Completed and up to Date
Health and Safety Elements .3
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Working Site Clean and Tidy
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PPE Available for Activities Undertaken
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Eyewash bottles are in date
Signing Lighting and Guarding .4
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Copy of The NRSWA Red Book available
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Is Chapter 8 Setup as Red Book Requirements
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Is Vehicle Traffic Being Controlled
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Is Pedestrian Traffic Being Controlled
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Courtesy Boards in Use
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Permit Board Out and in Use
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Access and Egress to Properties Acceptable
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Footpath Boards in Use and Secure
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Road Plates in Use and Secure
Excavation .5
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Are the Excavations as per the Route on the Design Plan
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Excavation is Shored Correctly (If Applicable)
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Trench Widths & Depths Are Acceptable for The Pipe Installation
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If Depths of cover are not achieved has a variation been approved by the Technical Advisor (In notes record variation and photograph evidence)
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Siting of Plant and Materials Near Excavations
Pipe Handling & Installation .6
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Gas Pipe Being Stored/Staked Correctly
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Fitting are All Bagged Until Use
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Plant Clearances acceptable
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Has Electrofusion Been Witnessed
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Are Scrapers Being Used
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Top Tee Clamp -1 Onsite and in Calibration
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Top Tee Clamp - 2 Onsite and in Calibration
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Joint Alignment Clamps in Use
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Has the Joint been Completed Correctly (e.g. Signs of etching, coupler marked and Installers Information on the Pipe)
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End Caps Available and in Use
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Weather Protection in Inclement Weather in Use (Pipe Protection)
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Bead Gauge (Butt Fusion Process) In Use
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Have the Appropriate Photos Been Submitted for the Activities Onsite
Testing .7
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Has the Test area Been Adequately Barriered off to Prevent Inadvertent Access
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Is the Test area Adequate to Allow the Monitoring of the Test Gauge without Entering the Excavation
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Is a Water Gauge Being use and is it Filled Correctly
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Mains on Test Sign Out and in Use
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Test Standpipe in Calibration
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LP Test Equipment (Comark) in calibration
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MP Test Equipment (Druck ONLY) in calibration
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Is Permit to Work on site for MP test
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Is the Testing Criteria Available and Understood by the Team
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Testing Hand Pump or Small Compressor in Use
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Compressor (For Testing) Onsite (Owned By, Plant Number, and Service Date Required)
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Is the Test Certification Onsite and being Completed during test
Connections .8
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Fire Extinguisher 1 Out Ready for Use and Fully Charged
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Fire Extinguisher 2 Out Ready for Use and Fully Charged
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BA 1 Available. Inspected and Ready for Use
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BA 2 Available. Inspected and Ready for Use
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NRO/ROU/PTW Onsite and Being Complied With
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Is Flame Retardant Clothing Being Worn
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Bypass Position Being Managed Safely
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Gascoseeker in Use and In Calibration
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Squeeze-Off Equipment in working condition and spare on site
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Vent Pipe/Stack in Use
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Purge Hose in Use
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Leak Detection Fluid in Use
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Re-Rounding Clamps Available
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Squeeze-Off Tape applied
Meter Installation Works .9
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Location of Meter Box is Acceptable
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Meter Box Integrity and Secured in Place
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MPRN label Attached and photographed
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MP label attached
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Internal meter location is ventilation acceptable
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MOB Pre-Commissioning Check List Completed
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MOB A3 Composite Label Sited Correctly
Backfilling .10
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Sand Bed and Pipe Surround Acceptable
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Marker Tape in Use and Acceptable
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Backfilling Material Acceptable
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Compaction to HAUC Acceptable
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Correct base and wearing course materials
Items for Calibration / Maintenance .11
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Electrofusion box
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Generator
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C.A.T Available
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GENNY Available
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Butt-fusion Box
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Extension leads Pack Tested
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Lifting Equipment - 1 In Date
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Lifting Equipment - 2 In Date
Record of Corrective Actions (Below) .12
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Comments
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Photographs
Signatures .13
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Team Leader Signature
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Auditor Signature