TasWater - Sewer Connection/Disconnection Completion Sheet (for Treloar, Paneltec & Select Plumbing)

• NC Number

• Property Address

• Suburb

• Scope of Work performed?

• Works Conducted on

  Date

• Prepared by

• Works Performed By?

  Select

• PID

• Title Reference number

• Photos of property prior to works being performed

  Media

• Upload photo/s of the TasWater Endorsed Plans used to perform the customer connection

  Media

• Upload photo/s of the CCW (Certificate Of Certifiable Work) *where applicable

  Media

Safety

• Traffic Management /control needed?

  Yes

  No

• Any Hazards on site have been added to SWMS spreadsheet & SWMS completed?

  Yes

  No

  N/A

New Sewer Connection photos

• Was a new sewer connection installed?

  Yes

  No

• If multiple sewer connections were installed please provide photos for each connection

• Photos showing the excavation works

  Media

• Photos showing the sewer connection point on TasWater infrastructure.

  Media

• Photos showing the installation of the pipe work

  Media

• Photos showing the installation of the IO (Inspection Opening)

  Media

Reinstatement of Works & Location Details

• If multiple sewer connections were installed please provide photos for each connection

• Photos showing backfill of sewer works

  Media

• Photos showing the installation of metallic detector tape

  Media

• Photos showing reinstatement of excavations works

  Media

• Photo showing reinstatement around the IO (Inspection Opening)

  Media

• Was a trafficable IO cover installed

  Yes

  No

• Photo showing installation of trafficable IO cover

  Media

Location details of sewer connection

• If multiple sewer connections were installed please provide location details for each connection

• The measurements from the property boundaries

• The length (in metres) of the connecting pipework from the main/manhole connection point to the IO.

• The depth (in millimetres) of the pipe work at the connection point and termination IO for sewer

• Northerly bearing for plan

  Select

New Sewer Connection information for Revenue Assurance

• Was a new sewer connection installed?

  Yes

  No

• How many sewer connections were installed?

• Sewer Connection Details no.1

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.1

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.2

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.1

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.2

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.3

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.1

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.2

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.3

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.4

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.1

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.2

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.3

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.4

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.5

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.1

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.2

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.3

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.4

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.5

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Sewer Connection Details no.6

• What size is the new sewer connection?

  Select

• Date of sewer install

  Date

• Is sewer installation complete?

  Yes

  No

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

Disconnection of Existing Sewer Connection Photos

• Was a sewer disconnection performed?

  Yes

  No

• Photos showing the excavation works

  Media

• Photos showing the existing sewer connection

  Media

• Photo showing the cap and seal of existing connection

  Media

• Photos showing backfill

  Media

• Reinstatement of excavation works

  Media

Location details of disconnection

• The measurements from the property boundaries to the disconnection point on TasWater mains.

• Northerly bearing for plan

  Select

Details of Existing Sewer Connection information for Revenue Assurance

• Was an existing sewer connection capped & sealed?

  Yes

  No

• How many existing sewer connections were capped and sealed?

• Disconnected Service details

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.1

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.2

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.1

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.2

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.3

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.1

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.2

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.3

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.4

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.1

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.2

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.3

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.4

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

• Disconnected Service details no.5

• What size was the existing sewer connection that was disconnected?

  Select

• Date of sewer disconnection

  Date

• Serviced Property (e.g. unit 1 or Lot 1)

• Description of property at time of works being performed?

  Vacant Land

  Under Construction

  Developed

Installation of new Maintenance Shaft photos

• Was a new Maintenance Shaft installed?

  Yes

  No

• Photos showing the excavation works

  Media

• Photos showing the installation of a new Maintenance Shaft

  Media

• Photos showing the backfill of excavation works

  Media

• Photos showing reinstatement

  Media

Location details of maintenance shaft

• The measurements from the property boundaries

• The length (in metres) of the connecting pipework from the mains connection point to the IO.

• The depth (in millimetres) of the pipe work at the connection point and termination IO for sewer

• Northerly bearing for plan for map

  Select

installation of new Manhole

• Was a new Manhole installed?

  Yes

  No

• Photos showing the excavation works

  Media

• Photos showing the installation of a new manhole

  Media

• Photos showing the backfill of excavation works

  Media

• Photos showing reinstatement

  Media

Location details of new manhole

• The measurements from the property boundaries

• The length (in metres) of the connecting pipework from the mains connection point to the IO.

• The depth (in millimetres) of the pipe work at the connection point and termination IO for sewer

• Northerly bearing for map

  Select

• Upload photo/s of map showing the sewer works performed, including disconnection and connection works.

  Media

• Upload photo/s of completed Sewer Service Disconnection & Connection Completion Form

  Media

• Full name of Panel Member onsite Supervisor (type full name and sign)

  Sign

• Full name of Panel Member onsite Plumber (type full name and sign)

  Sign

• Comments