Title Page
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Start Date
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Site Set Up (SLG, Safety Zone, Permit Board)
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Prepared by
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Location
Digging
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Are Services Correctly Marked?
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Any Hazards Regarding Utilities , E.G Within 10 Metres of Mains Services
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Explain
Photographic Evidence
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Photos Of Initial Dig
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Photo Of Blockage Located
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Photos Of Repair
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Photo Of Sub Base
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Photo Of Sand And Marker Tape
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Bitumen (not needed if in verge)
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Photos Of Surface Area (Tarmac , Verge etc)
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Reinstatement
Blockage 2 (If Needed)
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Photos Of Initial Dig
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Photo Of Blockage Located
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Photos Of Repair
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Photo Of Sub Base
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Photo Of Sand And Marker Tape
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Bitumen (not needed if in verge)
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Photos Of Surface Area (Tarmac , Verge etc)
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Reinstatement
Blockage 3 (If Needed)
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Photos Of Initial Dig
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Photo Of Blockage Located
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Photos Of Repair
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Photo Of Sub Base
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Photo Of Sand And Marker Tape
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Bitumen (not needed if in verge)
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Photos Of Surface Area (Tarmac , Verge etc)
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Reinstatement
Blockage 4 (If Needed)
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Photos Of Initial Dig
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Photo Of Blockage Located
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Photos Of Repair
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Photo Of Sub Base
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Photo Of Sand And Marker Tape
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Bitumen (not needed if in verge)
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Photos Of Surface Area (Tarmac , Verge etc)
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Reinstatement
Blockage 5 (If Needed)
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Photos Of Initial Dig
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Photo Of Blockage Located
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Photos Of Repair
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Photo Of Sub Base
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Photo Of Sand And Marker Tape
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Bitumen (not needed if in verge)
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Photos Of Surface Area (Tarmac , Verge etc)
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Reinstatement
Registration
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Reinstatement Measurements ( Length x Width x Depth )
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Photos Of Site Clearance
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Coordinates of blockage (Eastings & Northings)
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Finish Time And Date
