Information

  • Site Vantage Survey

  • Site Name:

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Add signature

  • Date and Time of Visit:

  • Year identified:

  • SSW22 Given to Landowner

  • Is there any mechanical excavation equipment working within 35m of the pipeline, or on a line that will cross the pipeline?

  • Is there any work on drainage , ditching, fencing or any other farm activity within the Vantage Point Survey area?

  • Is there any evidence of Bonfires or Bonfire Materials within 60 metres of the pipeline?

  • Is there any civil engineering or building/ demolition work of any kind?

  • Is there any evidence of tree felling or timber transportation?

  • Is there any discoloration of vegetation or other evidence of leakage?

  • Is there any evidence of Blasting, Mining or Mineral extraction?

  • Is there any evidence of ground movement or changes in watercourses?

  • Is there any evidence of removal of surface soil and conversely tipping and/or stacking of materials over the pipeline?

  • What is the general condition of the marker posts in the pipeline section i.e. mainly visible, broken, non-existent/not seen. Particular attention should be paid in the vicinity of quarries and watercourses.

  • What is the general condition of the easement and any licensed area/fencing that may be onsite?

  • Add Photo's of the condition of the fencing and notable hazards that require control or removal from site.

  • Sketch of area

  • Add signature

  • Customers Address
  • Customers 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.