Header Sheet
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Inspection Date :
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Inspection By (Full Name) :
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Document Number :
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FSAM / FDA Code :
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Inspection / Job I.D. :
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Staff / Sub-Contractor Name :
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Project Number (VPL use only) :
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Field Manager Responsible :
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Location
1. GENERAL / MANDATORY REQUIREMENTS
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1. OH&S Risks identified and addressed.<br>
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2. Environmental Risks Identified.
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3. Emergency contacts known.
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4. Dial Before You Dig (DYBD) Plans on site.
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5. Employees inducted & competent (VPL ID).
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6. Dedicated waste / disposal area allocated.
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7. Environmental controls have been forwarded to the field.
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8. Guards / Barriers / Signs positioned in correct locations.
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9. Traffic / Pedestrian Management in place.
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10. Traffic Management Plan completed.
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11. Temporary reinstatement completed.<br>
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12. Removal of Guards / Barriers / Signs.
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13. JSA & SWMS completed.<br>
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14. Practical Completion documents complete and accurate.
2. PRE-CONSTRUCTION
2.1 Site Survey.
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1. Assess Conduits/Pits and Complete Field Inspection Report (FIR) on iPad.
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2. Check Works Completion - Closure of Manholes and Pits.
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3. Check Works Completion - Waste & Barricades removed.<br>
2.2 Rod, Rope and Prove.
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1. Test for Gas in Manholes and Pits.<br>
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2. Correct conduit selected as per instruction pack.
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3. Correct Size Mandrel used.<br>
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Size of Mandrel used :
- None
- MA = 10.0 mm
- MB = 15.0 mm
- MC = 22.0 mm
- MD = 30.0 mm
- ME = 35.0 mm
- MF = 50.0 mm
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4. Identify location of blockage from A end to B end.
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5. Enough hauling rope installed & fit for use at both ends.
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Defect Type :
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Defect Location :
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Defect Description :
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Defect Photograph :
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Rectification Description :
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Rectify Defect By :
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6. Check for removal of waste, guards, barricades and signs.
