Title Page
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Feature ID
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Exchange
- Aberdare
- Barry
- Bridgend
- Cardiff
- Hengoed
- Neath
- Llanelli
- Morriston
- Newport
- Swansea
- Tonypandy
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Date
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Gang Lead
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Location
Health & Safety
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Have you completed a Risk Assessment (Ensure Safe Digs are in date & Cover Excavation Area) Upload pic of completed POWRA form.
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STOP work! Why haven't you completed a RA. EVERY job requires you to complete a suitable risk assessment
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Speed of road
- 20mph
- 30mph
- 40mph
- 50mph or above
- N/a - Private road or off-road only
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Do you have access on site to the "Safety at Street Works and Road Works. A Code of Practice"? (Red Book)
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Is this a HOT JOB? (Is there medium or high pressure pipeline in the vicinity)
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Has authorisation been given to dig from management? If the answer is "No", Stop work immediately and contact your supervisor.
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Confirm the name of person authorising excavation?
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Provide Photo evidence of calibrated CAT & GENNY (with cable clamp) and GDU available on site
Pre-Start
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Provide a minimum of 4 Pre-Start photos, at least one from all directions of excavation area (Take photos of immediate surroundings to show existing conditions and to protect yourself from any potential damage claims)
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Provide photos of existing services clearly marked up. You MUST include a perspective view photo of at least 5m radius otherwise it will fail validation (DO NOT JUST TAKE A CLOSE UP PIC)
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Provide Site Set-up photos at least one from each direction clearly showing the CORRECT Chapter 8 in place. Ensure your site is secure and fully barriered off to prevent public access.
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Provide photo clearly showing the planned location of the Toby box (marked up at pre build setting out) .
Existing Network Evidence
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Provide multiple photos of the exposed existing network before you carryout any installation. You MUST include a perspective view photo of at least 5m radius otherwise it will fail validation (DO NOT JUST TAKE A CLOSE UP PIC)
Specification
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TOBY BOX CONSTRUCTION SPECIFICATION
Installation Evidence
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Provide photos of in build progress showing placed duct and toby & Clear photos of where new duct / tee meets existing duct / Structure before covering cables with split / New duct.
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To pass validation where applicable a repair kit must be used and clearly visible on all joints to existing duct. Except when repairing 2" duct. Repairs of 2" duct must be on the outside of the existing duct either using 2" split duct the wider socket end of new duct or using a collar. (Do not split the duct and insert it into the existing)
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Provide photos of completed install BEFORE backfill. You MUST include a perspective view photo of at least 5m radius otherwise it will fail validation (DO NOT JUST TAKE A CLOSE UP PIC)
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Is the section clear?
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Provide photos of new rope installed from Toby Box to feeding chamber.
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Why?
Reinstatement Status
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Have you back filled the excavation?
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Why Not?
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Provide photos showing removal of spoil (excavated material) and the new backfill material used before and after compaction. If in FW or CW you must use clean Type1 aggregates to backfill.
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Have you reinstated the surface in tar?
- Yes
- No
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One material can be used in FW if correct specification is met. Refer to HAUC spec A7.1 for further details.
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Reinstatement MUST comply to HAUC Specification not just matching existing surface. Carefully select the correct method from this document. Refer to full specification in the HAUC if necessary
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Reinstatement Type Completed? (use above document to confirm specification)
- A7.1 (A) Tar FW - Permanent Reinstatement
- A7.1 (B) Tar FW - Temp Reinstatement
- A7.3 (A) Concrete FW - Permanent Reinstatement
- A7.3 (B) Concrete FW - Temp Reinstatement
- A7.4 (A) Modular FW (Flag / Block) - Permanent Reinstatement
- A7.4 (B) Modular FW (Flag / Block) - Temp Reinstatement
- A3.4 (A) Type 3 CW - Permanent Reinstatement
- A3.4 (B) Type 3 CW - Temp Reinstatement
- A3.5 (A) Type 4 CW - Permanent Reinstatement
- A3.5 (B) Type 4 CW - Temp Reinstatement
- A3.3 (A) Type 2 CW - Permanent Reinstatement
- A3.3 (B) Type 2 CW - Temp Reinstatement
- Another
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Provide Reinstatement photos showing use of edge sealant and depth measures of each course (Base & Surface) where applicable. You MUST include a perspective view photo of at least 5m radius otherwise it will fail validation (DO NOT JUST TAKE A CLOSE UP PIC)
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Have you reinstated the surface in verge / unsurfaced material
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Provide photos of fully reinstated surface (All verges must be top soiled and seeded). You MUST include a perspective view photo of at least 5m radius otherwise it will fail validation (DO NOT JUST TAKE A CLOSE UP PIC)
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Did you carry out any other reinstatement type?
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Are there any unresolved reinstatement requirements (e.g Concrete, Slabs, Block Paving, Coloured Surfaces, Anti Skid material, other)
Job Completion
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Surface Type
- 6mm Tar F/w
- 10mm Tar C/w
- Verge / Unsurfaced
- Concrete F/w
- Concrete C/w
- Block Paving / Flag F/w
- HRA
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Provide Dig dimensions: length x Width & Breakdown measures by surface/Type (e.g FW = 3.4m x 0.4m, CW = 8.2m x 0.3m) or (Chamber = 1.9m x 1.3m - F/w, Duct = 1.7m x 0.4m - F/w). Be accurate to avoid an FPN from the Council for recording wrong details.
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Does Excavation exceed 3m?
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Record Grid Reference at Start Point
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Record Grid Reference at End Point
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Exact Address of Dig (Please be as accurate as possible e.g O/s 13 Clover Way or Opp 2 Fir Tree Ave)
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Comments / Outcome (Provide detailed notes where necessary)
- Toby Box built as planned. LTC Install can go ahead.
- Build Failed. LTC Install on hold.
- Toby Box installed but further work required. LTC install can proceed.
- Other
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Why? Provide as much detail as possible
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Confirmation
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Is Job Complete, Reinstated & Site Clear
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Provide Site Clear or Left Safe Ready For Reinstatement Photos
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A55 Completed (ensure A55 is fully completed and accurate measures between chambers and blockages)
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Why is an A55 not required (an A55 is necessary for all excavations)
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Gang Lead Signature
