Calcium hypochlorite provided in each section of pipe per dosages noted in specifications. Where water piping crosses a sanitary sewer, minimum 18" vertical clearance and waterproof PVC water pipe sleeve (reference sanitary sewer materials) sealed at both ends for distance of 10' from sewer in both directions provided. Insulation is provided at top of and initial cover levels per specification requirements. 6” 1’ Initial cover and backfill materials and methods meet specification requirements. Open pipe ends capped at completion of work day. Negative Responses Date Found Date Found By Location Reason for Negative Response Resolved Resolved Resolution YES / NO YES / NO YES / NO YES / NO YES / NO D) FACILITY PIPING INSTALLATION CHECKS Questions (See details below) % Date Description of Work Performed Complete Initials 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) YES YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO CHECKLIST GROUP COMPLETE INITIALS: DATE:
Calcium hypochlorite provided in each section of pipe per dosages noted in specifications. Where water piping crosses a sanitary sewer, minimum 18" vertical clearance and waterproof PVC water pipe sleeve (reference sanitary sewer materials) sealed at both ends for distance of 10' from sewer in both directions provided. Insulation is provided at top of 6” and 1’ initial cover levels per specification requirements. Initial cover and backfill materials and methods meet specification requirements. Open pipe ends capped at completion of work day. Negative Responses Date Found Found By Location Reason for Negative Response Resolved Date Resolved Resolution YES / NO YES / NO YES / NO YES / NO YES / NO D) FACILITY PIPING INSTALLATION CHECKS Date Description of Work Performed % Complete Initials Questions (See details below) 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO CHECKLIST GROUP COMPLETE INITIALS: DATE:
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