Site Enabling Form

• QTS Surveyor

• Project Name

• Conducted on

  Date

• JT Number/Monitor Reference Number

• Client Person Contacted

• Location
  Address

Culvert Information

• Work Type

  Select CCTV De-Water De-Silt De-Veg Civils

  • CCTV
  • De-Water
  • De-Silt
  • De-Veg
  • Civils

• Issues Identified

  Select Headwall Damaged Existing CCTV Survey Watercourse Cables Through Culvert Debris Around Culvert Tree Removal

  • Headwall Damaged
  • Existing CCTV Survey
  • Watercourse
  • Cables Through Culvert
  • Debris Around Culvert
  • Tree Removal

• Purpose

  Foul

  Storm

  Chemical Effluent

• Material

  Select Brick Barrell Brick Arch VC Concrete Cast Iron Pitch Fibre MDPE

  • Brick Barrell
  • Brick Arch
  • VC
  • Concrete
  • Cast Iron
  • Pitch Fibre
  • MDPE

• Flow

  Low

  Medium

  High

• Debris

  Select Silt Mud Gravel Scale FOG Roots No Debris

  • Silt
  • Mud
  • Gravel
  • Scale
  • FOG
  • Roots
  • No Debris

• Levels

  25%

  50%

  75%

  100%

Measurements

• Manhole Depth (nearest 0.5m)

  Select N/A 0.5m 1m 1.5m 2.5m 3m 3.5m 4m 4.5m+

  • N/A
  • 0.5m
  • 1m
  • 1.5m
  • 2.5m
  • 3m
  • 3.5m
  • 4m
  • 4.5m+

• Length of Culvert (nearest 5m)

  Select 5m 10m 15m 20m 25m 30m 35m 40m 45m 50m 55m 60m 60m+

  • 5m
  • 10m
  • 15m
  • 20m
  • 25m
  • 30m
  • 35m
  • 40m
  • 45m
  • 50m
  • 55m
  • 60m
  • 60m+

• Diameter

  Select 150 225 300 375 450 600 750 825 900 1200 1500 1800 2000

  • 150
  • 225
  • 300
  • 375
  • 450
  • 600
  • 750
  • 825
  • 900
  • 1200
  • 1500
  • 1800
  • 2000

• Does it require keyclamp?

  Yes

  No

  N/A

• If Yes, give measurements.

Access

• Location of Downstream

  Off Road

  SSSI Site

  Trackside

  Verge

  Footpath

• Location of Upstream

  Off Road

  SSSI Site

  Trackside

  Verge

  Footpath

• Overnight Secure Storage?

  Yes

  No

  N/A

• Access

  Select EA Consent Permission From Landowner(s) NWR Access 3rd Party Access Signed Council Permission Payment Required Keys Required

  • EA Consent
  • Permission From Landowner(s)
  • NWR Access
  • 3rd Party Access Signed
  • Council Permission
  • Payment Required
  • Keys Required

• Is it a confined space?

  Yes

  No

  N/A

• Restricted Working

  Select Restricted Hours Possession Isolation Midweek Nights Saturday Night

  • Restricted Hours
  • Possession
  • Isolation
  • Midweek Nights
  • Saturday Night

• Sensitive Working

  Select Environmental Site Livestock School Residential Area Garden Access

  • Environmental Site
  • Livestock
  • School
  • Residential Area
  • Garden Access

• Traffic Management

  Select N/A Chapter 8 Stop/Go Boards Traffic Lights Footpath Closed

  • N/A
  • Chapter 8
  • Stop/Go Boards
  • Traffic Lights
  • Footpath Closed

• Tolls?

  Yes

  No

  N/A

Water & Waste

• Waste Type

  Select River Dredging 17 05 06 Interceptor Sludge 13 05 03 Sewer Waste 20 03 06 Street Cleaning 20 03 03

  • River Dredging 17 05 06
  • Interceptor Sludge 13 05 03
  • Sewer Waste 20 03 06
  • Street Cleaning 20 03 03

• Water Extraction

  Select Recycle Hydrant

  • Recycle
  • Hydrant

• Documents Required

  Select Method Statement Work Package Plan Task Briefing Risk Assessment

  • Method Statement
  • Work Package Plan
  • Task Briefing
  • Risk Assessment

• Waste Disposal

  Select On Site Landfill STW Skips

  • On Site
  • Landfill
  • STW
  • Skips

Equipment & Manpower

• Manpower

  Select Site Supervisor COSS Banksman/MC/CC Site Warden ES Machine Operator 4 Man Jet/Vac Team 3 Man Jet/Vac Team 3 Man Civils Team 2 Man De-Veg Team 2 Man CCTV Team

  • Site Supervisor
  • COSS
  • Banksman/MC/CC
  • Site Warden
  • ES
  • Machine Operator
  • 4 Man Jet/Vac Team
  • 3 Man Jet/Vac Team
  • 3 Man Civils Team
  • 2 Man De-Veg Team
  • 2 Man CCTV Team

• Jetting Hose Length

  Select 50m 100m 150m 200m 250m 250m+

  • 50m
  • 100m
  • 150m
  • 200m
  • 250m
  • 250m+

• Suction Hose Length

  Select 50m 100m 150m 200m 250m 250m+

  • 50m
  • 100m
  • 150m
  • 200m
  • 250m
  • 250m+

• Equipment

  Select Jet/Vac Lorry Recycler CCTV Portable Unit 4x4 Hydrainer Pump 2" Submersible Pump Generator Mitigation Hand Digging Tools De-Vegging Equipment Mini-Excavator Large Excavator Remote Reel Remote Reel x 2 Remote Reel x 3

  • Jet/Vac Lorry
  • Recycler
  • CCTV Portable Unit
  • 4x4
  • Hydrainer Pump
  • 2" Submersible Pump
  • Generator
  • Mitigation
  • Hand Digging Tools
  • De-Vegging Equipment
  • Mini-Excavator
  • Large Excavator
  • Remote Reel
  • Remote Reel x 2
  • Remote Reel x 3

• Qualifications

  Select First Aid Site Induction PTS Confined Space Jet/Vac Qualified CCTV Qualified De-Veg Qualified

  • First Aid
  • Site Induction
  • PTS
  • Confined Space
  • Jet/Vac Qualified
  • CCTV Qualified
  • De-Veg Qualified

• Vehicle Size Issue?

  Yes

  No

  N/A

Timescales

• Worksite Requirements

  Select Green Zone Red Zone Line Blocks Possession Isolation Overheads 3rd Rail Off Track

  • Green Zone
  • Red Zone
  • Line Blocks
  • Possession
  • Isolation
  • Overheads
  • 3rd Rail
  • Off Track

• Estimated Shifts

  Select 1 2 3 4 5 6+

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6+

• Timescales

  Select Dayshift Nightshift Working Away

  • Dayshift
  • Nightshift
  • Working Away

Other Information

• Any Other Information

Sketch Plan & Photographs

• Photos of Inlet Access

  Media

• Photos of Inlet Headwall/Entrance

  Media

• Photos of Outlet Access

  Media

• Photos of Outlet Headwall/Entrance

  Media

• Other Photos (site drawing, 3rd Party info etc.)

  Media

• Sketch Plan

  Media

• Signature from Surveyor

  Sign