Title Page

  • Conducted on

  • Prepared by

  • Location

  • Project

  • Client

  • Contractor

  • Site Conditions

Safety

  • Are TTM's in place and in accordance with plans?

  • Is correct PPE being used?

  • Are open trenches protected using bunting, fencing or similar?

  • Are trenches over 1.5m benched, battered or are shoring boxes in use?

  • Are materials being stored safely?

  • Are there any other safety concerns? If so detail, photograph and assign actions. Note: If there is an immediate risk to a persons safety then instruct the works to stop and contact the person in control of the site as well as Spiire Construction team.

Environmental

  • Is contractor working in accordance with the approved EPA drawings?

  • Is dust being suppressed during excavation and backfilling of trenches?

  • Are there any other concerns regarding Environmental issues? If so detail, photograph and assign actions.

Trench Excavation

  • Does trench width conform with Icon Water standards and design drawings?

  • Is there any groundwater present at base of trench? If so please detail method used for bedding and haunch and photograph.

  • Is base of trench free from rocks and loose material?

Pipe Installation

  • Does bedding material conform with Icon Water standards? If so sight site specific grading certificate.

  • Are pipes and shorts compliant with the Icon Water approved product list?

  • Is the correct jointing method being used by the contractor?

  • Are the correct revision of design drawings being followed by the contractor?

  • Are property ties installed correctly with concrete or compacted dry premix behind the junction and min/max depths inside boundary adhered to?

  • Have shorts been installed correctly with sanded piece embedded in concrete and socket/spigot facing correct way?

  • Is road sub base material approved and passing grading requirements? If so sight grading certificate.

  • Is select material free from organic material and particle sizes greater than 75mm?

Sewer structures

  • Is the structure as per approved drawing in relation to size and construction method?

  • Are step irons in compliance with standards and approved product list?

  • Is the neck height compliant with Icon Water standards?

  • Has correct class of lid been used as per approved drawings?

  • Has manhole been trowel finished or rubbed back to remove any dags or sharp edges?

  • Does manhole base comply with Standards and approved drawing? If offset is shown on drawing has thing been done?

Finals

  • Have compaction test been done on trench fill and do they meet compaction requirements?

  • Are sewer lines and manhole bases clean and ready for finals testing?

  • Has all Ovality testing passed? Take copy of compliance certificate for Prooving tool and ensure serial number matches.

  • Has all pressure testing passed? Take a copy of compliance certificate for pressure gauge and ensure serial number matches.

  • Has all vacuum testing passed? Take a copy of the compliance certificate for vacuum gauge and ensure serial number matches.

  • Has CCTV been done on line selected by Icon Water and are there any possible issues?

  • Have connection points been witnessed and do they line up with existing network?

  • Are any manhole lids damaged or marked with Stormwater?

  • Have gattic lids been greased and bolted down if required?

  • Comments

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.