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
- Helmet
- Ear Protection
- Safety Shoes
- Vest
- Gloves
- Dust Mask
- Welding Mask
- Safety Glasses
- Safety harness
- Protective Clothing
- Others
-
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