Title Page
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Week Start Date
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Week End Date
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Prepared by
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Location
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Contractor Representative
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Project name
Monday
Site Safety Management
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MSDS onsite?
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SWMS Onsite?
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JSA onsite and complete?
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Safety Management plan onsite?
Environmental Management
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Silt Barriers erected?
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All tree/bush pruning and clearing in accordance with the REF?
Traffic Management
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Approved Traffic Control Plans onsite?
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All signs erected in accordance with the Traffic Control Plan?
Utility location
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Visual pegged/marked/located?
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Correct alignment?
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DBYD onsite?
Excavation
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Trench depths in accordance with plans?
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Trench width in accordance with plans?
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Trench support in accordance with Safe Work Australia, Excavation work Code of Practice
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Extra Excavation required?
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Amount
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Rock Excavation required?
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Amount
Water Main Construction
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Bedding Material
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Bedding material 100mm(min) thick
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PN16 PVCM pipe installed in center of trench?
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Hydrants installed as per plan?
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Reason
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was new location approved prior to installation
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Valves and bends installed as per plan?
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Reason
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Was new location approved prior to installation?
-
Pipe sleeve installed as per plan? (DI pipe)
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Thrust/Anchor blocks installed as per plan?
-
Trench stops/Bulkheads installed as per plan?
-
Pipe support/Overlay material
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Pipe overlay 150mm(min) above top of pipe
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Detectable location tape installed?
Water Services
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PN16 SDR11 PE pipe used?
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Type A copper used?
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Bedding/Overlay material
-
Correct cover over pipe (500mm)
-
Detectable location tape installed?
Backfill
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Backfill material
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backfill compaction
Commissioning
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Pressure test
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section tested
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section tested
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test result
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Cut in/Connection
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Was 48hrs notice given before water shutdown
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New main flushed and Chlorinated?
Daily Sign Off
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Council Superintendent
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Contractor Representative
Tuesday
Site Safety Management
-
MSDS onsite?
-
SWMS Onsite?
-
JSA onsite and complete?
-
Safety Management plan onsite?
Environmental Management
-
Silt Barriers erected?
-
All tree/bush pruning and clearing in accordance with the REF?
Traffic Management
-
Approved Traffic Control Plans onsite?
-
All signs erected in accordance with the Traffic Control Plan?
Utility Location
-
Visual pegged/marked/located?
-
Correct alignment?
-
DBYD onsite?
Excavation
-
Trench depths in accordance with plans?
-
Trench width in accordance with plans?
-
Trench support in accordance with Safe Work Australia, Excavation work Code of Practice
-
Extra Excavation required?
-
Amount
-
Rock Excavation required?
-
Amount
Water Main Construction
-
Bedding Material
-
Bedding material 100mm(min) thick
-
PN16 PVCM pipe installed in center of trench?
-
Hydrants installed as per plan?
-
Reason
-
was new location approved prior to installation
-
Valves and bends installed as per plan?
-
Reason
-
was new location approved prior to installation?
-
Pipe sleeve installed as per plan? (DI pipe)
-
Thrust/Anchor blocks installed as per plan?
-
Trench stops/Bulkheads installed as per plan?
-
Pipe support/Overlay material
-
Pipe overlay 150mm(min) above top of pipe
-
Detectable location tape installed?
Water Services
-
PN16 SDR11 PE pipe used?
-
Type A copper used?
-
Bedding/Overlay material
-
Correct cover over pipe (500mm)
-
Detectable location tape installed?
Backfill
-
Backfill material
-
backfill compaction
Commissioning
-
Pressure test
-
Section tested
-
section tested
-
test result
-
Cut in/Connection
-
was 48hrs notice given before water shutdown
-
New main flushed and Chlorinated?
Daily Sign Off
-
Council Superintendent
-
Contractor Representative
Wednesday
Site Safety Management
-
MSDS onsite?
-
SWMS Onsite?
-
JSA onsite and complete?
-
Safety Management plan onsite?
Environmental Management
-
Silt Barriers erected?
-
All tree/bush pruning and clearing in accordance with the REF?
Traffic Management
-
Approved Traffic Control Plans onsite?
-
All signs erected in accordance with the Traffic Control Plan?
Utility Location
-
Visual pegged/marked/located?
-
Correct alignment?
-
DBYD onsite?
Excavation
-
Trench depths in accordance with plans?
-
Trench width in accordance with plans?
-
Trench support in accordance with Safe Work Australia, Excavation work Code of Practice
-
Extra Excavation required?
-
Amount
-
Rock Excavation required?
-
amount?
Water Main Construction
-
Bedding Material
-
Bedding material 100mm(min) thick
-
PN16 PVCM pipe installed in center of trench?
-
Hydrants installed as per plan?
-
Reason
-
Was the alteration approved?
-
Valves and bends installed as per plan?
-
Reason
-
was the alteration approved?
-
Pipe sleeve installed as per plan? (DI pipe)
-
Thrust/Anchor blocks installed as per plan?
-
Trench stops/Bulkheads installed as per plan?
-
Pipe support/Overlay material
-
Pipe overlay 150mm(min) above top of pipe
-
Detectable location tape installed?
Water Services
-
PN16 SDR11 PE pipe used?
-
Type A copper used?
-
Bedding/Overlay material
-
Correct cover over pipe (500mm)
-
Detectable location tape installed?
Backfill
-
Backfill material
-
backfill compaction
Commissioning
-
Pressure test
-
section tested
-
test result
-
section tested
-
Cut in/Connection
-
Was 48hrs notice given for water shut down
-
New Main Flushed and hypo chlorinated?
Daily Sign Off
-
Council Superintendent
-
Contractor Representative
Thursday
Site Safety Management
-
MSDS Onsite?
-
SWMS Onsite?
-
JSA onsite and completed?
-
Safety Management Plan onsite?
Environmental Management
-
Silt Barriers Erected?
-
All tree/bush pruning and clearing done as per the REF?
Traffic Management
-
Approved Traffic control plans onsite?
-
All signs erected in accordance with the traffic control plan?
Utility location
-
Visual pegged/marked/located?
-
Correct alignment?
-
DBYD onsite?
Excavation
-
Trench depths in accordance with the plan?
-
Trench width in accordance with the plan?
-
Trench support in accordance with Safe Work Australia, Excavation work code of Practice
-
Extra Excavation Required?
-
amount
-
Excavation of rock required?
-
amount
Water main Construction
-
bedding Material
-
Bedding 100mm(min) thickness
-
PN16 PVCM pipe installed in center of trench?
-
Hydrants installed as per plan?
-
reason
-
has new location been approved prior?
-
Valves and bends installed as per plan?
-
reason
-
was change of location approved?
-
Pipe sleeve installed as per plan? (DI pipe)
-
Thrust/Anchor blocks installed as per plan?
-
Trench stops/Bulkheads installed as per plan?
-
Pipe support/Overlay material
-
Pipe overlay 150mm(min) above top of pipe
-
Detectable location tape installed?
Water Services
-
PN16 SDR11 PE pipe used?
-
Type A copper used?
-
Bedding/Overlay material
-
Correct cover over pipe (500mm)
-
Detectable location tape installed?
Backfill
-
Backfill material
-
backfill compaction
Commissioning
-
Pressure Test
-
section tested
-
section tested
-
result
-
Cut in/Connection
-
was 48hr notice given for water shutdown
-
Nw main flushed and chlorinated
Daily Sign Off
-
Council Superintendent
-
Contractor Representative
Friday
Site Safety Management
-
MSDS Onsite?
-
SWMS Onsite?
-
JSA onsite and completed?
-
Safety Management Plan onsite?
Environmental Management
-
Silt Barriers Erected?
-
All tree/bush pruning and clearing done as per the REF?
Traffic Management
-
Approved Traffic control plans onsite?
-
All signs erected in accordance with the traffic control plan?
Utility location
-
visually pegged/marked/located?
-
Correct alignment?
-
DBYD onsite?
Excavation
-
Trench depths in accordance with the plan?
-
Trench width in accordance with the plan?
-
Trench support in accordance with Safe Work Australia, Excavation work code of Practice?
-
Extra Excavation Required?
-
amount
-
Excavation of rock required?
-
amount
Water Main construction
-
bedding Material
-
Bedding 100mm(min) thickness
-
PN16 PVCM pipe installed in center of trench?
-
Hydrants installed as per plan?
-
reason
-
was new location approved prior to installation/
-
Valves and bends installed as per plan?
-
reason
-
Was new location approved prior to installation?
-
Pipe sleeve installed as per plan? (DI pipe)
-
Thrust/Anchor blocks installed as per plan?
-
Trench stops/Bulkheads installed as per plan?
-
Pipe support/Overlay material
-
Pipe overlay 150mm(min) above top of pipe
-
Detectable location tape installed?
Water Services
-
PN16 SDR11 PE pipe used?
-
Type A copper used?
-
Bedding/Overlay material
-
Correct cover over pipe (500mm)
-
Detectable location tape installed?
Backfill
-
Backfill material
-
backfill compaction
Commissioning
-
Pressure Test
-
Section tested
-
section tested
-
Test result
-
Cut in/Connection
-
was 48hrs notice given for water shutdown?
-
New main flushed and chlorinated?
Daily sign Off
-
Council Superintendent
-
Contractor Representative