Water & Sewer Take 5

• Conducted on

  Date

• Job Location

• Job Description

  Repair water main

  Repair water service

  New water service

  Other

• Additional description

• Completed by

  Matthew Runge

  Other

• Completed by name

Checklist

• Traffic Control/ Pedestain

  Yes

  No

  N/A

• Pedestrian

• Add media

  Media

• TCP

  Select S.9.1.7 - RTA TC Manual TCP 83 Lane Closure Road Closure Other

  • S.9.1.7 - RTA TC Manual
  • TCP 83
  • Lane Closure
  • Road Closure
  • Other

• Add media

  Media

• Locate Service underground overhead

  Yes

  No

  N/A

• Dial before you dig

  Yes

  No

  N/A

• Telstra/ Fibre Optic

  Yes

  No

  N/A

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  Media

• Power

  Yes

  No

  N/A

• Details

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  Media

• Other

  Yes

  No

  N/A

• Details

• Overhead

  Yes

  No

  N/A

• Spotter

  Spotter not required

  3m (132000v)

  6m (33000v)

  8m (Above 330000v)

• Dialysis Machines

  Yes

  No

  N/A

• Controls

• Weather

  Good

  Wet

  Windy

• Area of Concern

• Area of Concern

• PPE Required

  Select Hard hat Dust mask Eye Proctection Gloves Other

  • Hard hat
  • Dust mask
  • Eye Proctection
  • Gloves
  • Other

• Other Controls

• Nominated first-aid officer

  Matthew Runge

  Other

• First-aid officer name

• Staff signature

  Sign

• Additional staff signature (optional)

  Sign

• Additional staff signature (optional)

  Sign

• Additional staff signature (optional)

  Sign