Title Page
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Specific Work Type
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What time did you set off to come to this job? (includes travel time and tar collection)?
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How long were you onsite (minimum duration 1hr & including time to travel back to original location)
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How much asphalt (tonnes) have you used (including base and surface course) example: 2 x Barrows base = 0.2t
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Feature ID
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Exchange
- Hengoed
- Neath
- Morriston
- Swansea
- Bridgend
- Llanelli
- Tonypandy
- Aberdare
- Llantrisant
- Barry
- Newport
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Date
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Gang Lead
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Location
Health & Safety
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Have you completed a Risk Assessment (Ensure Safe Digs are in date & Cover Excavation Area) Upload pic of completed POWRA form.
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STOP work! Why haven't you completed a RA. EVERY job requires you to complete a suitable risk assessment
Pre-Start
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Provide a minimum of 4 Pre-Start photos, at least one from all directions of excavation area (Take photos of immediate surroundings to show existing conditions and to protect yourself from any potential damage claims)
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Provide Site Set-up photos at least one from each direction clearly showing the CORRECT Chapter 8 in place. Ensure your site is secure and fully barriered off to prevent public access.
Reinstatement Evidence
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Provide photos of cut back and show depth of existing surface (Use Tape measure / Depth board)
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Photos of edge sealant on all vertical edges
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Photo of compacted backfill including aspect view at least 5m radius (NOT JUST A CLOSE UP)
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Reinstatement MUST comply to HAUC Specification not just matching existing surface. Carefully select the correct method from this document. Refer to full specification in the HAUC if necessary
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Reinstatement Type
- A7.1 (A)
- A7.1 (B)
- A7.3 (A)
- A7.4 (A)
- A3.4 (A)
- A3.4 (B)
- A3.5 (A)
- A3.5 (B)
- A3.3 (A)
- A3.3 (B)
- Another
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Provide Reinstatement photos showing depth measure of base course. You MUST include a perspective view photo of at least 5m radius otherwise it will fail validation (DO NOT JUST TAKE A CLOSE UP PIC)
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Provide Reinstatement photos showing depth measure of surface course. You MUST include a perspective view photo of at least 5m radius otherwise it will fail validation (DO NOT JUST TAKE A CLOSE UP PIC)
Job Completion
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Dig dimensions: length x Width - Breakdown measures by surface/Type (e.g FW = 3.4m x 0.4m, CW = 8.2m x 0.3m) or (Chamber = 1.9m x 1.3m - F/w, Duct = 1.7m x 0.4m - F/w)
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Does reinstatement exceed 3m?
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Record Grid Reference at Start Point
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Record Grid Reference at End Point
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Is all reinstatement Complete
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Provide site clear photos from both directions
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Provide photos of site left safe & secure until return visit
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Please add any additional relevant information
Confirmation
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Gang Lead Signature