MODEL ECONOMIC TOWNSHIP

INSPECTION CHECKLIST FOR PIPELINE WORKS

Date:

Node From – To/Location:- DI/HDPE PIPE LAYING

Chainage From:-................. Chainage To:- .............. Length:-.............................................

Dia & Class of Pipe:............................................ No. of Pipes x Length...................................
Bedding Yes No
Required Cushion Yes No

Cleaning of pipe Yes No

Special Fixing & Chainage: ........................................................................................................

Air valve/Scour valve/Sluice valve Fixing details (Ch.).....................................................................................

Backfilling as per specification Yes No

Excavation Details:-

Chainage Width Total Layer Thickness Detail Remarks

Depth CC BT WBM SR HR E/W PB any other
From To
Layer No.

(All measurement in Meter)

Manpower/Labour details Machinery / Equipment details

Name of PRW agency
Supervisor Skilled Unskilled Excavator Crane Tractor Trolley Other

Comments, if any:
.................................................................................................................................................................................................
.................................................................................................................................................................................................
.................................................................................................................................................................................................

CONTRACTOR CONSULTANT METL

Name & Signature Name & Signature Name & Signature