Title Page

  • Site conducted

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  • Environment Agency Area

  • Watercourse ID

Site Location

  • Add location
  • Conducted on

  • Prepared by

Culvert Inlet

  • Inlet Location - GPS
  • Traffic Management

  • Landowner

  • Site Information (Including contact details)

  • Culvert Height mm

  • Culvert Width mm

  • Water Level mm

  • Silt Depth mm

  • Speed of flow recorded at time of survey

  • Material

  • Asset Photos

Culvert Outlet

  • Outlet Location - GPS
  • Traffic Management

  • Landowner

  • Site Information (Including contact details)

  • Culvert Height mm

  • Culvert Width mm

  • Water Level mm

  • Silt Depth mm

  • Speed of flow recorded at time of survey

  • Material

  • Asset Photos

Additional Assets

    Additional Assets
  • Asset Type

  • Location - GPS
  • Photos of Manhole

  • undefined

  • Traffic Management

Additional photos

Additional photos - photos can be loaded in groups. It's is easier to add how many groups you would like to add first.

  • Add photos

  • Photo Group
  • Add media

  • undefined

Work Details

  • Nature of works

  • Culvert Confined Space Classification

Risk Rating - Low, Medium, High.

  • Risk Classification of the Confined Space.

Man Entry Requirements

  • Do we need to enter the Confined Space

  • Number of men for task

  • Culvert Length

  • Silt sample required

  • CCTV Additional Requirements/info

Additional Equipment

  • Additional Equipment Required

T98 Condition Grade (Visual Inspection)

  • Condition grade of the culvert

Summary of findings

  • undefined

Work recommendations to client

  • undefined

Planning / Risk Control

Control of Risk

  • If there are any aspects of the work which is not covered by RAM Utility Solutions generic RAMs then additional information and planning to control the risk is required. This is achieved by answering the relevant section below to identify the specific additional risks to cover.

  • Overhead Services

  • Information on services

  • Photos of Overhead services

Pollution & Environmental Control

Environmental & pollution control

  • Record any habitat and bio diversity issues identified (aquatic, plants, animals, sensitive or endangered flora & fauna)

  • Will the works impact downstream?

  • Detail what measures need to be taken to control this

  • Is there any risk to fish?

  • Detail the controls will be in place

  • Is there a pollution risk?

  • Detail the controls in place

  • Pollution risk

  • Is the flow of the watercourse likely to change during the duration of the works?

  • undefined

Sign Off

Report Complete

  • Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.