Title Page

  • Week Start Date

  • Week End Date

  • Prepared by

  • Location
  • Contractor Representative

  • Project name

Monday

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

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

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