Title Page

  • Burst Type

  • Potable or raw water?

  • Conducted on

  • Prepared by

  • Location
  • Description of burst site

Burst Information

Location

  • Distance to nearest surface water feature (could include ditch). Any surface water drainage eg. road gulley should also be identified and distance from burst reported.

  • Is the burst located within any Designated land?

  • What designation is the burst within?

  • Have the relevant statutory bodies been informed?

  • Is supervision required?

  • What type of habitat is the burst located in?

  • Has the burst impacted the visual habitat?

  • Please explain and attach photos

  • Will the repair works require the removal or destruction of any habitat (trees, hedges, scrub, impact to river banks etc.)

  • Please explain.

  • Has a habitat and wildlife survey been conducted?

  • Please explain why. If one was conducted at a later time please include in explanation.

  • How has the habitat been affected by the leak? How will the habitat be affected by the repair works?

  • Has any wildlife been identified? What is there a potential for? How will the wildlife be affected by the repair works?

  • Is there any sediment in the watercourse?

  • How much is there? What sediment is in the watercourse? Please attach photos of the sediment.

Environment Agency

  • Have the EA been informed of the leak?

  • Why not?

  • Have chlorine tests been conducted by a technician?

  • Why not?

  • What were the results? (can fill in once results have been obtained)

  • Have other samples been taken?

  • If yes, what?

  • Have the EA been sent the following: Observations, Photos, Sample Results?

Repair Works

  • Who is conducting the repair?

  • Who is the site supervisor?

  • Are appropriate environmental mitigations in place?

  • Please explain:

  • Please list environmental mitigations in place. Please attach photos:

  • Please note down (with images) the description and process of the repair works occurring:

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