Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Location
  • Prepared by

  • Personnel

Environmental Precautions

  • Is there any precautions related to Noise Control ?

  • Explain the reason

  • Take a Photo of the situation

  • Is there any precautions related to Waste Control ?

  • Explain the reason

  • Take a Photo of the situation

  • Is there any precautions related to Dust Control ?

  • Explain the reason

  • Take a Photo of the situation

H&S Precautions

  • Are barriers located and secured the excavation area on site ?

  • Explain the reason ?

  • Take a Photo of the situation

  • Are equipments, machines and transportation vehicles in a good state, having no noxious effects concerning environment and human life ? ( H&S Plan )

  • Are there pedestrian access near the working area and pedestrian bridge on trench to across ?

  • Is there any vehicle access near the working area ?

  • Is ladder provided properly to go down into the trench and go out from the trench ?

  • Are materials stocked up safely on working area ?

  • Are site signs provided properly at working area ?

  • Is fire extinguisher provided properly ?

  • Is first medical aid provided properly ?

  • Is the personnel protective equipment (ppe) provided?

  • Define the person who is not used the PPE.

  • Person
  • Name and Surname

  • Photo of him

  • Define the PPE is not used or proper

  • Is asbestos appeared during the working ?

  • Is asbestos removal study necessary ?

  • Suspend the work immediately. Inform the Engineer and MESKI.

  • Contractor's Staff

  • Consultant's Site Supervisor

Excavation

  • Is the length complied the specifications and drawings ? ( GTS 5.1.5.1 )

  • Explanation

  • Is the depth complied with the design drawings ?

  • Explanation

  • Define the soil type

  • Length

  • Average Depth

  • Add media

  • Does ground water occur in excavation pit ?

  • Take a Photo of the situation

  • Define the dewatering method

  • Is there any trench shoring ? (GTS 5.1.5.5, GTS 5.2.6.3 )

  • Take a Photo of the situation

  • Explanation

Pipelaying

  • Do pipes and fittings comply the specifications ? ( GTS 5.2.2, PTS 1.2.1 )

  • Take a Photo of the situation

  • Explanation

  • Are butt welding, electro fusion welding or mechanical jointing techniques applied properly between HDPE pipes ?

  • Is cooling period of butt or electro fusion weldings, which are applied between HDPE pipes, complied with the principles ?

  • Are bedding and filling materials complied the specifications ? ( GTS 5.1.6.1, PTS 1.2.1 )

  • Take a Photo of the situation

  • Explanation

  • Is the Filling material thickness complied ? ( GTS 5.1.6.1 )

  • Indicating that the mechanical compaction above the pipe should be started at least 30 cm. ( GTS 5.2.6.7 )

  • Are line and grade of pipelaying correct ? ( GTS 5.2.6 )

  • Is F/O cable conduit placed correctly ? ( PTS 4.13.5 )

  • Take a Photo of the situation

  • Explanation

  • Are F/O cable detectable tapes placed correctly ? ( PTS 4.13.5 )

  • Take a Photo of the situation

  • Explanation

  • Is excavated material suitable for backfilling ? ( GTS 5.1.6.1 )

  • Take a Photo of the situation

  • Explanation

  • Is backfilling material complied ?

  • Take a Photo of the situation

  • Explanation

  • Is backfilling compacted correctly ? ( GTS 5.1.6.2 )

  • Is there any trench that the depth is lower than 1.00 m ?

  • Is concrete cover, where the depth of pipe is less than 1.00 m, complied ? ( GTS 5.2.6.8 )

  • Take a Photo of the situation

Additional Comment

Signature

  • Contractor's Site Staff

  • Consultant Site Supervisor

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