R20A Civil Inspection Daily Audit

• PM#

• Prepared by

• Foreman's Name

• Conducted on

  Date
• Location
  Address

• Valid USA ticket?

  Yes

  No

  N/A

• Was a Tailboard Completed?

  Yes

  No

• List Locations

Trench and Conduit

• 1. Depth of trench

  Pass

  Fail

  N/A

• 2. Sand Bed/Shade

  Pass

  Fail

  N/A

• 3. Backfill

  Pass

  Fail

  N/A

• 4. Compaction Test Report

  Pass

  Fail

  N/A

• 5. Wet Utility Clearance

  Pass

  Fail

  N/A

• 6. Dry Utility Clearance

  Pass

  Fail

  N/A

• 7. Shoring

  Pass

  Fail

  N/A

• 8. EMS Marker Ball

  Pass

  Fail

  N/A

• 9. End Balls

  Pass

  Fail

  N/A

• 10. Pull Tape

  Pass

  Fail

  N/A

• 11. Mandrel

  Pass

  Fail

  N/A

• 12. Horizontal Directional Drilling

  Pass

  Fail

  N/A

• 13. Cross Bore Inspection

  Pass

  Fail

  N/A

Pad, Splice, Box, and Vault

• 14. Location Grade

  Pass

  Fail

  N/A

• 15. Vehicle Access

  Pass

  Fail

  N/A

• 16. Primary Enclosure

  Pass

  Fail

  N/A

• 17. Secondary Enclosure / Splice Box

  Pass

  Fail

  N/A

• 18. Aggregate

  Pass

  Fail

  N/A

• 19. Compaction Test Results

  Pass

  Fail

  N/A

• 20. Pre-Cast Pad

  Pass

  Fail

  N/A

• 21. Poured Pad

  Pass

  Fail

  N/A

• 22. Dry Vault

  Pass

  Fail

  N/A

• 23. Lid Adjustment Bolt / Support Bracket

  Pass

  Fail

  N/A

• 24. Lid Grounded

  Pass

  Fail

  N/A

• 25. Ground Rod Instrument / Grounding

  Pass

  Fail

  N/A

• 26. Caulking

  Pass

  Fail

  N/A

• 27. Conduit Couplings / Glue

  Pass

  Fail

  N/A

• 28. Clearance Working Space

  Pass

  Fail

  N/A

• 29. Retaining Wall

  Pass

  Fail

  N/A

• 30. Ground Rod, Clamp, and Ufer

  Pass

  Fail

  N/A

• 31. Hardware (Bolt, anchors, and lids)

  Pass

  Fail

  N/A

• 32. Barrier Post / Diameter / Visibility Strips

  Pass

  Fail

  N/A

• 33. Landscaping Obstructions

  Pass

  Fail

  N/A

Inspector Notes:

• Add any notes below.

• Civil Inspectors Name

  Sign