Street Lighting (RMS/Council) Yes Yes Yes Yes Yes Yes No No No No No No Other Yes Yes Yes Yes Yes Yes No No No No No No Underground Assets Location Checklist University of Sydney-Owned Utilities – This information must be obtained by contractor from the CIS Information Manager. Utility on in to (1) visibly works ground due requires requires of and and on University assets verified presence services excavation plans (1) by holing site existing marking works Current University Assets University University utility pot proximity on during attached vicinity site received to indicate locating infrastructure Electricity Yes Yes Yes Yes Yes No No No No No Gas Yes Yes Yes Yes Yes No No No No No Water Yes Yes Yes Yes Yes No No No No No Sewer Yes Yes Yes Yes Yes No No No No No Stormwater Drainage Yes Yes Yes Yes Yes No No No No No Communications Yes Yes Yes Yes Yes No No No No No Street Lighting Yes Yes Yes Yes Yes No No No No No Irrigation Yes Yes Yes Yes Yes No No No No No Decommissioned Services Yes Yes Yes Yes Yes No No No No No Other Yes Yes Yes Yes Yes No No No No No Note 1: Details of when the University requires these actions is determined by the type of asset and available clearances, in strict accordance with Table B of the WorkCover Work Near Underground Assets Guide 2007 (See Attachment 1 to this Form) Other Assets in Vicinity Trees and Tree Roots Yes Adjacent Buildings and Yes Overhead Powerlines Yes No Structures No No Chemical Stores Yes Petroleum Services Yes Above/underground Yes No No Storage Tanks No Yes Yes Yes No No No PART C POTENTIAL WORKS HAZARDS (other than those listed in Part B) – The following additional hazards have been identified for the proposed works and incorporated into the excavation works plan Slips, Trips and Falls Yes Excavation Collapse Yes Traffic Yes No No No Difficult Excavation Yes Vibration Yes Pedestrian Control Yes Access and Egress No No No Manual Handling Yes Soil Contaminants Yes Excavation Flooding Yes No No No Heavy Machinery Yes Airborne Contaminants Yes Hot Works Yes No No No
Street Lighting (RMS/Council) Yes No Yes No Yes No Yes No Yes No Yes No Other Yes No Yes No Yes No Yes No Yes No Yes No Underground Assets Location Checklist – University of Sydney-Owned Utilities This information must be obtained by contractor from the CIS Information Manager. Utility Current University utility plans received and attached University indicate assets in vicinity Assets verified on site by services locating and visibly marking on ground University requires pot holing due to proximity of works to existing infrastructure (1) University requires on site presence during excavation works (1) Electricity Yes No Yes No Yes No Yes No Yes No Gas Yes No Yes No Yes No Yes No Yes No Water Yes No Yes No Yes No Yes No Yes No Sewer Yes No Yes No Yes No Yes No Yes No Stormwater Drainage Yes No Yes No Yes No Yes No Yes No Communications Yes No Yes No Yes No Yes No Yes No Street Lighting Yes No Yes No Yes No Yes No Yes No Irrigation Yes No Yes No Yes No Yes No Yes No Decommissioned Services Yes No Yes No Yes No Yes No Yes No Other Yes No Yes No Yes No Yes No Yes No Note 1: Details of when the University requires these actions is determined by the type of asset and available clearances, in strict accordance with Table B of the WorkCover Work Near Underground Assets Guide 2007 (See Attachment 1 to this Form) Other Assets in Vicinity Trees and Tree Roots Yes No Adjacent Buildings and Structures Yes No Overhead Powerlines Yes No Chemical Stores Yes No Petroleum Services Yes No Above/underground Storage Tanks Yes No Yes No Yes No Yes No PART C – POTENTIAL WORKS HAZARDS (other than those listed in Part B) The following additional hazards have been identified for the proposed works and incorporated into the excavation works plan Slips, Trips and Falls Yes No Excavation Collapse Yes No Traffic Yes No Difficult Excavation Access and Egress Yes No Vibration Yes No Pedestrian Control Yes No Manual Handling Yes No Soil Contaminants Yes No Excavation Flooding Yes No Heavy Machinery Yes No Airborne Contaminants Yes No Hot Works Yes No
CIS%20Standards%20-%20Permit%20to%20Dig%20Form%20(CIS-ENG-F003).docx