James Sorraghan

SMEC Sewer Inspection and Audit Form

Use this Template

Print as PDF

Use this Template

Go digital today!

Convert your paper checklists into digital forms

Scan this QR code to use this paper checklist on your smartphone or tablet or visit https://safetyculture.com/

Title Page

Conducted on
Prepared by
Project

Site Management

Site Management
Registered pipelayer?
Registered pipelayer Onsite?
2. Drawings on site and current?
Add media

Occupational Health and Safety

Occupational Health and Safety
Appropriate PPE worn?
Appropriate trench safety measures in place?
Other?
Add media

Trench Excavation

Trench Excavation
Section checked ?
Trench width?
Within tolerance?
Add media

Pipe Laying

Pipe Laying
Section checked ?
Pipe centrally placed?
Pipe laser in use
Pipe material
Pipe diameter
Pipe class
Date of manufacture
Add media

Embedment

Embedment
Section checked
Embedment specified
Embedment Verified
Add media

Backfill

Backfill
Section checked
Backfill type
- CR Backfill
- Clay Backfill
- Other
Evidence of compaction

Manholes and Structures

Manholes and Structures
Structure(s) Checked
Rocker pipe free of concrete
Formwork in good condition
Mechanical vibration used

James Sorraghan

SMEC Sewer Inspection and Audit Form

Use this Template

Print as PDF

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.