Question Details Exterior piping installed below predicted frost level, but in no case less than 5' bury depth to top of pipe. Excavation and backfill procedures meet specification requirements. Bedding and backfill material meet specifications. Tracer wire is installed on non-metallic piping. Underground warning tape installed 6"-12" below finished grade above all exterior below ground piping. 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) TESTING & FINALIZATION CHECKS Questions (See details below) % Date Description of Work Performed Complete Initials 1) 2) 3) 4) 5) 6) 7) YES YES YES YES YES YES YES NO NO NO NO NO NO NO YES YES YES YES YES YES YES NO NO NO NO NO NO NO YES YES YES YES YES YES YES NO NO NO NO NO NO NO YES YES YES YES YES YES YES NO NO NO NO NO NO NO YES YES YES YES YES YES YES NO NO NO NO NO NO NO YES YES YES YES YES YES YES NO NO NO NO NO NO NO YES YES YES YES YES YES YES NO NO NO NO NO NO NO YES YES YES YES YES YES YES NO NO NO NO NO NO NO CHECKLIST GROUP COMPLETE INITIALS: DATE:
Question Details Exterior piping installed below predicted frost level, but in no case less than 5' bury depth to top of pipe. Excavation and backfill procedures meet specification requirements. Bedding and backfill material meet specifications. Tracer wire is installed on non-metallic piping. Underground warning tape installed 6"-12" below finished grade above all exterior below ground piping. 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) TESTING & FINALIZATION CHECKS Date Description of Work Performed % Complete Initials Questions (See details below) 1) 2) 3) 4) 5) 6) 7) 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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